Petersen Jesper Koefod, Fjaellegaard Katrine, Rasmussen Daniel Bech, Alstrup Gitte, Høegholm Asbjørn, Sidhu Jatinder Sing, Bhatnagar Rahul, Clementsen Paul Frost, Laursen Christian B, Bodtger Uffe
Respiratory Research Unit PLUZ, Department of Internal and Respiratory Medicine, Zealand University Hospitals, Roskilde and Næstved, 4000 Roskilde, Denmark.
Institute of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark.
Diagnostics (Basel). 2024 Jun 3;14(11):1176. doi: 10.3390/diagnostics14111176.
Malignant pleural effusion (MPE) affects up to 15% of patients with malignancy, and the prevalence is increasing. Non-expandable lung (NEL) complicates MPE in up to 30% of cases. However, it is not known if patients with malignant pleural effusion and NEL are more symptomatic in activities of daily living compared to patients with MPE with expandable lung.
This was an observational study on consecutively recruited patients with MPE from our pleural clinic. Before thoracentesis, patients completed patient-reported outcomes on cancer symptoms (ESAS), health-related quality of life (5Q-5D-5L), and dyspnoea scores. Following thoracentesis, patients scored dyspnoea relief and symptoms during thoracentesis. Data on focused lung ultrasound and pleural effusion biochemistry were collected. The non-expandable lung diagnosis was made by pleural experts based on radiological and clinical information.
We recruited 43 patients, including 12 with NEL (28%). The NEL cohort resembled those from previous studies concerning ultrasonography, pleural fluid biochemistry, and fewer cases with high volume thoracentesis. Patients with and without NEL were comparable concerning baseline demography. The 5Q-5D-5L utility scores were 0.836 (0.691-0.906) and 0.806 (0.409-0.866), respectively, for patients with and without NEL. We observed no between-group differences in symptom burden or health-related quality of life.
While the presence of NEL affects the clinical management of recurrent MPE, the presence of NEL seems not to affect patients' overall symptom burden in patients with MPE.
恶性胸腔积液（MPE）影响高达15%的恶性肿瘤患者，且患病率呈上升趋势。不可扩张肺（NEL）在高达30%的MPE病例中使其复杂化。然而，与具有可扩张肺的MPE患者相比，患有恶性胸腔积液和NEL的患者在日常生活活动中是否症状更明显尚不清楚。
这是一项对从我们胸腔诊所连续招募的MPE患者进行的观察性研究。在胸腔穿刺术前，患者完成关于癌症症状（ESAS）、健康相关生活质量（5Q-5D-5L）和呼吸困难评分的患者报告结局。胸腔穿刺术后，患者对呼吸困难缓解情况和胸腔穿刺期间的症状进行评分。收集聚焦肺超声和胸腔积液生物化学数据。不可扩张肺的诊断由胸腔专家根据放射学和临床信息做出。
我们招募了43名患者，其中12名患有NEL（28%）。NEL队列在超声检查、胸腔积液生物化学方面与先前研究的队列相似，且大量胸腔穿刺的病例较少。有和没有NEL的患者在基线人口统计学方面具有可比性。有和没有NEL的患者的5Q-5D-5L效用评分分别为0.836（0.691-0.906）和0.806（0.409-0.866）。我们未观察到组间在症状负担或健康相关生活质量方面的差异。
虽然NEL的存在会影响复发性MPE的临床管理，但NEL的存在似乎不会影响MPE患者的总体症状负担。
