The American journal of medicine · 2026
A retrospective study of the usefulness of pleural effusion and blood indicators and ratios in detecting benign and malignant pleural effusion.
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Chen Dan, Jiang Fengying, Liu Qingyang, Wang Qiubo
Аннотация
BACKGROUND: This study aimed to identify markers and ratios in serum and pleural fluid that could accurately differentiate between benign and malignant pleural effusion.
METHODS: A total of 251 patients with pleural effusion were enrolled. 49 patients had a clinical diagnosis of cancer (malignant group), while 202 patients had benign lesions (benign group). Relevant pleural and blood biomarkers were measured. Multivariate logistic regression and receiver operating characteristic curve analysis were conducted to discover significant indicators and ratios.
RESULTS: Univariate analysis revealed significant differences in multiple parameters between the two groups. Multivariate analysis identified pleural fluid lactate dehydrogenase, total protein, adenosine deaminase, and glucose as the most valuable indicators for distinguishing malignant from benign pleural effusion (P < 0.05). The ratios of pleural fluid total protein to serum adenosine deaminase and pleural fluid lactate dehydrogenase to serum adenosine deaminase exhibited optimal diagnostic efficiency, with area under the curve (AUC) values of 0.833 and 0.802, respectively. At cut-off values of 3.34 and 19.87, the two ratios yielded sensitivities of 79.59% and 81.63% and specificities of 72.00% and 71.00% for malignant pleural effusion.
CONCLUSION: The two ratios discussed above served as valuable diagnostic markers for distinguishing malignant pleural effusion from benign pleural effusion.
METHODS: A total of 251 patients with pleural effusion were enrolled. 49 patients had a clinical diagnosis of cancer (malignant group), while 202 patients had benign lesions (benign group). Relevant pleural and blood biomarkers were measured. Multivariate logistic regression and receiver operating characteristic curve analysis were conducted to discover significant indicators and ratios.
RESULTS: Univariate analysis revealed significant differences in multiple parameters between the two groups. Multivariate analysis identified pleural fluid lactate dehydrogenase, total protein, adenosine deaminase, and glucose as the most valuable indicators for distinguishing malignant from benign pleural effusion (P < 0.05). The ratios of pleural fluid total protein to serum adenosine deaminase and pleural fluid lactate dehydrogenase to serum adenosine deaminase exhibited optimal diagnostic efficiency, with area under the curve (AUC) values of 0.833 and 0.802, respectively. At cut-off values of 3.34 and 19.87, the two ratios yielded sensitivities of 79.59% and 81.63% and specificities of 72.00% and 71.00% for malignant pleural effusion.
CONCLUSION: The two ratios discussed above served as valuable diagnostic markers for distinguishing malignant pleural effusion from benign pleural effusion.