ErNP@SiO2-ICG NIR Probes Enhance Thoracoscopy for Diagnosing Malignant Pleural Effusion in Internal Medicine.

BACKGROUND

The study investigated the efficacy of internal thoracoscopy combined with multi-site biopsy and erbium nanoparticle-containing silica-indocyanine green composite covered (ErNP@SiO2-ICG) near-infrared fluorescent probe technology in the diagnosis of malignant pleural effusion.

METHODS

Internal medicine: This procedure was conducted on 90 patients with pleural effusion at the Department of Respiratory Medicine of the Second People's Hospital of Hefei City between January 2021 and October 2024. The procedure included pleural biopsy, pleural fluid staining, near-infrared fluorescence biopsy system analysis, and cytology of pleural effusion.

RESULTS

Out of the 90 patients who had thoracoscopies, 20 had an unclear diagnosis, 35 had benign lesions, and 35 had malignant lesions. Thoracoscopy had a positive predictive value of 75.80%, a negative predictive value of 73.00%, a sensitivity of 71.40%, a specificity of 77.10%, and a concordance rate of 74.29% matched with pathological diagnosis for malignant lesions. The positive predictive value for the diagnosis of malignant pleural effusion increased to 80.00% when paired with an ErNP@SiO2-ICG near-infrared fluorescent probe. The negative predictive value was 82.90%, the degree of certainty was 82.40%, the specificity was 80.60%, and there was good concordance with the final pathological results (Kappa value of 0.629, p < 0.001).

CONCLUSIONS

Internal thoracoscopy has a high detection rate and accuracy in the diagnosis of pleural effusion, and when combined with the ErNP@SiO₂-ICG near-infrared fluorescent probe technology, it improves the diagnostic accuracy of malignant pleural effusion.