Heffner John E
Oregon Health & Science University, Portland, OR, USA.
Respirology. 2008 Jan;13(1):5-20. doi: 10.1111/j.1440-1843.2007.01154.x.
Malignant pleural effusions (MPEs) complicate the clinical course of patients with a broad array of malignancies, which are most often due to lymphomas or carcinomas of the breast, lung, gastrointestinal tract or ovaries. Patients may present with a MPE as the initial manifestation of a cancer or develop an effusion during the advanced phases of a known malignancy. In either circumstance, the median survival after presentation with a MPE is 4 months. Effusions may result from direct pleural invasion (MPE) or indirect effects (paraneoplastic effusions), such as impairment of fluid efflux from the pleural space by lymphatic obstruction or pleural effects of cancer radiation or drug therapy. Because only 50% of patients with cancer who develop a pleural effusion during their clinical course have a MPE, careful evaluation of the effusion to establish its aetiology is required to direct therapy. Management is palliative with interventions directed towards decreasing the volume of intrapleural fluid and the severity of associated symptoms.
恶性胸腔积液（MPEs）使众多恶性肿瘤患者的临床病程复杂化，这些肿瘤最常见于淋巴瘤或乳腺癌、肺癌、胃肠道癌或卵巢癌。患者可能以MPE作为癌症的初始表现，或在已知恶性肿瘤的晚期出现胸腔积液。在这两种情况下，出现MPE后的中位生存期为4个月。胸腔积液可能由直接胸膜侵犯（MPE）或间接影响（副肿瘤性胸腔积液）导致，例如因淋巴管阻塞使胸腔内液体流出受损，或癌症放疗或药物治疗的胸膜效应。由于在临床病程中出现胸腔积液的癌症患者仅有50%患有MPE，因此需要对胸腔积液进行仔细评估以确定其病因，从而指导治疗。治疗是姑息性的，采取旨在减少胸腔内液体量和相关症状严重程度的干预措施。
