General Surgery, S. Maria degli Angeli Hospital, Pordenone, Italy
University of Padua, School of Medicine, Padua, Italy.
Anticancer Res. 2020 Feb;40(2):1135-1139. doi: 10.21873/anticanres.14054.
BACKGROUND/AIM: The purposes of this study were to evaluate the usefulness of chest computed tomographic (CT) scan plus pleural fluid cytology (PFC) together in patients with malignant pleural effusion (PE), and to compare the results of these diagnostic tools in patients with malignant PE due to non-small-cell lung cancer and pulmonary metastases from other malignancies.
The medical records of 185 patients with PE, who underwent chest CT, PFC and video-assisted thoracoscopy (VATS) thoracentesis followed by VATS-guided biopsy for diagnostic purpose, were reviewed. At the final diagnosis, 123 (66.5%) patients had malignant PE (cases), and 62 (33.5%) had benign PE (controls).
Overall, the sensitivity, specificity, and accuracy of CT and PFC were 65.0% vs. 67.5% 98.4% vs. 98.4%, and 76.2% vs. 77.8%, respectively. The combination of CT plus PFC significantly improved sensitivity (86.2%, p=0.003) and accuracy (90.8%, p=0.02).
CT and PFC used together may lead to approximately 100% specificity and >90% sensitivity in distinguishing between benign and malignant PE.
背景/目的：本研究旨在评估胸部计算机断层扫描（CT）加胸腔积液细胞学（PFC）联合用于恶性胸腔积液（PE）患者的效用，并比较这些诊断工具在非小细胞肺癌和其他恶性肿瘤肺转移引起的恶性 PE 患者中的结果。
回顾了 185 例 PE 患者的病历，这些患者接受了胸部 CT、PFC 和视频辅助胸腔穿刺术（VATS）胸腔穿刺术，随后进行了 VATS 引导下活检以进行诊断。最终诊断为 123 例（66.5%）恶性 PE（病例）和 62 例（33.5%）良性 PE（对照）。
总体而言，CT 和 PFC 的敏感性、特异性和准确性分别为 65.0% vs. 67.5%、98.4% vs. 98.4%和 76.2% vs. 77.8%。CT 加 PFC 的联合显著提高了敏感性（86.2%，p=0.003）和准确性（90.8%，p=0.02）。
CT 和 PFC 联合使用可在鉴别良性和恶性 PE 时实现接近 100%的特异性和＞90%的敏感性。
