Bashour Sami I, Mankidy Babith J, Lazarus Donald R
Division of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
Respir Med. 2022 May;196:106802. doi: 10.1016/j.rmed.2022.106802. Epub 2022 Mar 9.
Roughly 150,000 malignant pleural effusions (MPE) are diagnosed in the United States each year. The majority of cases are caused by lung and breast cancer, and since MPE represents advanced disease, the prognosis is generally poor. In this article we review the pathophysiology, epidemiology, and prognosis of MPE. We then discuss the approach to diagnosis of MPE including the role of imaging, pleural fluid analysis, and medical thoracoscopy. Current management strategies for symptomatic MPE include repeated thoracentesis for patients with very limited life expectancy as well as more definitive procedures such as chemical pleurodesis, tunneled indwelling pleural catheters, and novel combined approaches. The choice of intervention is guided by the efficacy, local expertise, and risk, as well as patient factors and preferences.
在美国，每年大约有15万例恶性胸腔积液（MPE）被诊断出来。大多数病例由肺癌和乳腺癌引起，由于MPE代表晚期疾病，其预后通常较差。在本文中，我们回顾了MPE的病理生理学、流行病学和预后。然后我们讨论了MPE的诊断方法，包括影像学、胸腔积液分析和内科胸腔镜检查的作用。有症状的MPE的当前管理策略包括对预期寿命非常有限的患者进行反复胸腔穿刺术，以及更具确定性的程序，如化学性胸膜固定术、隧道式留置胸腔导管和新型联合方法。干预措施的选择取决于疗效、当地专业知识和风险，以及患者因素和偏好。
