A Combination of Ultrasound Characteristics with Macroscopic and Biochemical Features to Diagnose the Etiology of Lymphocytic Pleural Effusions.

Autor: Piskac Zivkovic N; Special Hospital Radiochirurgia Zageb, 10000 Zagreb, Croatia., Cvetko D; Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, 10000 Zagreb, Croatia., Zivkovic M; Department of Laboratory Diagnostics, University Hospital Dubrava, 10000 Zagreb, Croatia., Simac B; Department of Laboratory Diagnostics, University Hospital Dubrava, 10000 Zagreb, Croatia., Zelenika Margeta M; Department of Internal Medicine, Division of Pulmonology, University Hospital Dubrava, 10000 Zagreb, Croatia., Kovacevic I; Department of Internal Medicine, Division of Pulmonology, University Hospital Dubrava, 10000 Zagreb, Croatia., Malnar Janes L; Department of Internal Medicine, Division of Pulmonology, University Hospital Dubrava, 10000 Zagreb, Croatia., Lalic K; Department of Internal Medicine, Division of Pulmonology, University Hospital Dubrava, 10000 Zagreb, Croatia., Guzvinec Z; Department of Anesthesiology and ICU, University Hospital Centre Zagreb, 10000 Zagreb, Croatia., Ljilja Posavec A; Polyclinic for Respiratory Tract Diseases, 10000 Zagreb, Croatia., Feljan H; Special Hospital Radiochirurgia Zageb, 10000 Zagreb, Croatia., Vergles M; Department of Internal Medicine, Division of Pulmonology, University Hospital Dubrava, 10000 Zagreb, Croatia., Kuster Z; Department of Ultrasound and Nuclear Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2023 Nov 22; Vol. 13 (23). Date of Electronic Publication: 2023 Nov 22.
DOI: 10.3390/diagnostics13233502
Abstrakt: Objectives: The primary aim of this study was to improve the diagnosis of lymphocytic pleural effusions (LPEs) by combining their ultrasound characteristics with their macroscopic and biochemical features.
Methods: This prospective, single-center, clinical observational study was conducted over a period of three years. The possible malignant etiology of LPEs was assessed using several diagnostic criteria: 1. ultrasound characteristics of the LPEs; 2. typical combinations of macroscopic and ultrasound features; and 3. the logistic regression method with three parameters-pleural nodularity, absence of fibrin, and serum protein concentration.
Results: Eighty-four patients with LPEs were included in this study. Pleural nodularity (first criterion) was an ultrasound characteristic that yielded the best individual results ( p < 0.001) in the differentiation of malignant and nonmalignant etiologies of LPEs (accuracy 73.81%). The combination of the second and third criteria yielded the best results in the prediction of a malignant etiology of LPEs (sensitivity 90.48%, specificity 83.33%, PPV 84.44%, NPV 89.74%, accuracy 86.90%). Based on the results of this prospective study, a protocol for the diagnostic procedure of lymphocytic pleural effusions without a definitive fluid diagnosis has been proposed.
Conclusions: A combination of the ultrasound characteristics of LPEs and their macroscopic and biochemical features has improved the predictive accuracy for the malignant etiology of LPEs.
Databáze: MEDLINE
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