Anevlavis Stavros, Kouliatsis George, Sotiriou Ioannis, Koukourakis Michael I, Archontogeorgis Kostas, Karpathiou Georgia, Giatromanolaki Alexandra, Froudarakis Marios E
Department of Pneumonology, Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Respiration. 2014;87(4):311-6. doi: 10.1159/000356764. Epub 2014 Jan 22.
The survival of patients with malignant pleural effusion is considered generally poor. Most of the studies reporting results of prognostic factors are retrospective, using pleural thoracentesis for diagnosis. The objectives of our study were to reveal possible prognostic factors in patients initially presenting with undiagnosed pleural effusion proven to be malignant by diagnostic thoracoscopy.
Ninety consecutive patients, 48 of whom were male (53%), with a median age of 69 years (range 37-93) and a performance status (PS) of 0/1 (63%) and with initially undiagnosed pleural effusion that was proven to be malignant by thoracoscopy were evaluated. Survival time was defined as the time from thoracoscopic diagnosis to death or the last follow-up. A regression analysis was used to determine significant clinical and biological prognostic factors.
Lung carcinoma (44.4%), breast carcinoma (24.4%), and mesothelioma (12.2%) were the most frequent tumors diagnosed. The median overall survival was 11 months (range 0.5-55). The survival of the patients was related to the following factors: histology of the primary tumor (p = 0.008), PS (p < 0.001), white blood cells (p = 0.018), and the blood neutrophil-to-lymphocyte (N/L) ratio (p = 0.002). Multiple regression showed PS, histology, and the N/L ratio.
The factors affecting survival in our patients were PS, primary tumor histology, and the N/L ratio. These factors may help physicians select patients for treatment and/or interventional procedures.
恶性胸腔积液患者的生存率一般被认为较差。大多数报告预后因素结果的研究都是回顾性的，采用胸腔穿刺术进行诊断。我们研究的目的是揭示最初表现为未确诊胸腔积液且经诊断性胸腔镜检查证实为恶性的患者可能的预后因素。
对90例连续患者进行评估，其中48例为男性（53%），中位年龄69岁（范围37 - 93岁），体能状态（PS）为0/1的患者占63%，最初胸腔积液未确诊且经胸腔镜检查证实为恶性。生存时间定义为从胸腔镜诊断到死亡或最后一次随访的时间。采用回归分析确定显著的临床和生物学预后因素。
最常诊断出的肿瘤为肺癌（44.4%）、乳腺癌（24.4%）和间皮瘤（12.2%）。中位总生存期为11个月（范围0.5 - 55个月）。患者的生存与以下因素相关：原发肿瘤的组织学类型（p = 0.008）、PS（p < 0.001）、白细胞（p = 0.018）以及血液中性粒细胞与淋巴细胞比值（N/L）（p = 0.002）。多元回归显示为PS、组织学类型和N/L比值。
影响我们患者生存的因素为PS、原发肿瘤组织学类型和N/L比值。这些因素可能有助于医生选择患者进行治疗和/或干预措施。
