Paramalign ve malign plevral sıvısı olan hastaların retrospektif analizi

Öz

Amaç: Giderek artan insidansa sahip olan plevral sıvılar (PS), önemli bir klinik durumdur ve çeşitli nedenlere bağlı olarak ortaya çıkabilir. Bu çalışmanın amacı, malign plevral sıvı (MPS) ve paramalign plevral sıvı (PMPS) tanısı alan hastaların radyolojik histopatolojik ve biyokimyasal değerlerinin retrospektif olarak incelemektir. Gereç ve Yöntemler: Bu çalışmada göğüs hastalıkları ve göğüs cerrahisi kliniklerinde tanısal torasentez yapılmış 477 hasta incelendi. Hastalar MPS ve PMPS olmak üzere 2 gruba ayrıldı. Torasentez işlemi ile elde edilen veriler iki grup arasında karşılaştırıldı. İstatistiksel analizler SPSS 17.0 programı kullanılarak yapıldı. Bulgular: Çalışmamızda torasentez yapılan 477 hastanın dosyası incelendi. Benign plevral sıvı tanısı alan 313 olgu ve PET-BT raporuna ulaşılamayan 96 olgu çalışma dışı bırakıldı. Çalışmaya yaş ortalaması 65,7±10,1 olan 29’u (%42,6) kadın toplam 68 olgu dahil edildi. PS albümin değeri grup 1 de 23,7±10,8, grup 2 de 18±13,2 ile p değeri 0,055 bulunarak istatistiksel olarak anlamlı bulunmadı. PS LDH değeri grup 1 de 558±616, grup 2 de 369,8±520,9 olarak görüldü Her iki grup arasında biyokimyasal, radyolojik ve histopatolojik veriler değerlendirildiğinde istatistiksel olarak anlamlı fark bulunamadı. Sonuç: Araştırmamızın sonucunda istatistiksel olarak anlamlı verilere ulaşamasak ta daha fazla sayıda hasta ile geniş ölçekli çalışmalar yapıldığında biyokimyasal sonuçlar ve plevral sıvı FDG tutulumları açısından farklı sonuçlar elde edilebileceğine inanıyoruz. Anahtar Kelimeler: Paramalign plevral sıvı; malign plevral sıvı; torasentez

Anahtar Kelimeler

• malign effüzyon
• paramalign effüzyon
• torasentez

Retrospective analysis of patients with paramalignant and malignant pleural effusion

Öz

ABSTRACT Aim: Pleural effusion (PE) is an important clinical condition with an increasing incidence and can occur due to various causes. The aim of this study was to retrospectively analyze the radiologic, radiometabolic, histopathologic and biochemical findings of patients with malignant pleural effusion (MPE) and paramalignant pleural effusion (PMPE). Materials and Methods: In this study, 477 patients who underwent thoracentesis in the pulmonology and thoracic surgery clinics were analyzed. Patients were divided into 2 groups as MPE and PMPE. Data obtained by thoracentesis were compared between the two groups. Statistical analyses were performed using SPSS 17.0 program. Results: In our study, the files of 477 patients who underwent thoracentesis were evaluated. We excluded 313 patients diagnosed with benign pleural effusion and 96 patients whose PET-CT reports were not available. A total of 68 patients, 29 (42.6%) of whom were women with a mean age of 65.7±10.1 years, were included in the study. PS albumin value was 23.7±10.8 in group 1 and 18±13.2 in group 2 with a p value of 0.055, which was not statistically significant. PS LDH value was 558±616.9 in group 1 and 369.8±520.9 in group 2. No statistically significant difference was found between the two groups when biochemical, radiologic, radiometabolic and histopathologic data were evaluated. Conclusion: Although we could not reach statistically significant data as a result of our study, we believe that different results can be obtained in terms of biochemical results and pleural effusion FDG uptake when large-scale studies are performed with a larger number of patients.

Anahtar Kelimeler

• malign effusions
• paramalign effusions
• thoracentesis

Kaynakça

1. 1. Ferreiro L, San José ME, Valdés L. Management of parapneumonic pleural effusion in adults. Arch Bronconeumol. 2015;51(12):637-646.
2. 2. Light R. Pleural diseases. 5th Edition. Philadelp-hia: Wolters Kluwer/Lippincott Wiliams & Wil-kins. 2007;109-132.
3. 3. Light RW, Rogers JT, Moyers JP, et al. Tedder M. Prevalence and clinical course of pleural effusions at 30 days after coronary artery and cardiac surgery. Am J Respir Crit Care Med. 2002;15:1567-71.
4. 4. Light RW, MacGregor MI, Luchsinger PC, et al. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med. 1972;77(4):507-13.
5. 5. Arınç S. Managementof malign pleural effusion. Solunum. 2007;9:37-42.
6. 6. Aydin Y, Turkyilmaz A, Intepe YS, Eroglu A. Malignant pleural effusions: appropriate treatment approaches. Eurasian J Med. 2009;41(3):186-93.
7. 7. DeBiasi E, Puchalski J. Pleural effusions as markers of mortality and disease severity: a state-of-the-art review. Curr Opin Pulm Med. 2016;22(4):386-91.
8. 8. Akkurt B, Parmaksız ET, Doğan C, et al. The Role of PET-CT in the differential diagnosis of malignant-paramalignant pleural effusion. South. Clin. Ist. Euras. 2019;30(4):315-319.

9. 9. Tanseli E, Gönlügür U. 454 Plevral Efüzyonun Retrospektif Analizi, İnönü Üniversitesi Tıp Fakültesi Dergisi. 2007;14(1) 21-25.
10. 10. Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ, BTS Pleural Disease Guideline Group. Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guide-line. Thorax. 2010;65:32-40.
11. 11. Haberal MA, Sengoren Dıkıs O, Akar E. Evaluation of pleural effusions: Malignant and paramalignant. Akd Med J. 2020;6(2):203-208.
12. 12. Treglia G, Sadeghi R, Annunziata S, et al. Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in the assessment of pleural abnormalities 318 South. Clin. Ist. Euras. in cancer patients: a systematic review and a meta-analysis. Lung Cancer. 2014;83:1-7.
13. 13. Sun Y, Yu H, Ma J, Lu P. The role of 18F-FDGPET/CT integrated imaging in distinguishing malignant from benign pleural effusion. PloS One 2016;11:e0161764.
14. 14. Korczyński P, Mierzejewski M, Krenke R, Sa-fianowska A, Light RW. Cancer ratio and other new parameters for differentiation between malignant and nonmalignant pleural effusions. Pol Arch Intern Med. 2018;128(6):354-361.