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Predictive Factors and Treatment Outcomes of Tuberculous Pleural Effusion in Patients With Cancer and Pleural Effusion.

Abstract Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied.
PMID
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Authors

Mayor MeshTerms
Keywords

Cancer

Malignant pleural effusion

Pleural effusion

Tuberculous pleural effusion

Journal Title the american journal of the medical sciences
Publication Year Start




PMID- 28864369
OWN - NLM
STAT- MEDLINE
DA  - 20170902
DCOM- 20170908
LR  - 20170908
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 354
IP  - 2
DP  - 2017 Aug
TI  - Predictive Factors and Treatment Outcomes of Tuberculous Pleural Effusion in
      Patients With Cancer and Pleural Effusion.
PG  - 125-130
LID - S0002-9629(17)30212-4 [pii]
LID - 10.1016/j.amjms.2017.04.006 [doi]
AB  - BACKGROUND: Patients with cancer are at an increased risk of tuberculosis. As
      pleural effusion has great clinical significance in patients with cancer, the
      differential diagnosis between tuberculous pleural effusion (TPE) and malignant
      pleural effusion (MPE) is important. However, the predictive factors and
      treatment outcomes of TPE in patients with cancer have rarely been studied.
      MATERIALS AND METHODS: Confirmed TPE cases identified at cancer diagnosis and
      during anticancer management from 2008-2015 were retrospectively investigated.
      Patients in the study included coexisting TPE and cancer (n = 20), MPE (n = 40)
      and TPE without cancer (n = 40). Control groups were patients with MPE, and
      patients with TPE without cancer. Clinical, laboratory and pleural fluid
      characteristics were compared among groups. Treatment outcomes were compared
      between patients with TPE with and without cancer. RESULTS: In the final
      analysis, serum C-reactive protein (S-CRP) >/=3.0mg/dL and pleural fluid
      adenosine deaminase (ADA) >/=40U/L were independent predictors for identifying
      TPE in patients with cancer having pleural effusion. The combination of S-CRP
      with pleural fluid ADA using an "or" rule achieved a sensitivity of 100%, whereas
      both parameters combined in an "and" rule had a specificity of 98%. Treatment
      outcomes were not different between the TPE groups with and without cancer.
      CONCLUSIONS: S-CRP and pleural fluid ADA levels may be helpful for predicting TPE
      in patients with cancer with pleural effusion. The combination of these
      biomarkers provides better information for distinguishing between TPE and MPE in 
      these patients. Treatment outcomes of TPE in patients with cancer are comparable 
      to those in patients without cancer.
CI  - Copyright (c) 2017 Southern Society for Clinical Investigation. Published by
      Elsevier Inc. All rights reserved.
FAU - Lee, Jaehee
AU  - Lee J
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Lee, Yong Dae
AU  - Lee YD
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Lim, Jae Kwang
AU  - Lim JK
AD  - Department of Radiology, Kyungpook National University School of Medicine, Daegu,
      South Korea.
FAU - Lee, Deok Heon
AU  - Lee DH
AD  - Department of Thoracic and Cardiovascular Surgery, Kyungpook National University 
      School of Medicine, Daegu, South Korea.
FAU - Yoo, Seung Soo
AU  - Yoo SS
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Lee, Shin Yup
AU  - Lee SY
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Cha, Seung Ick
AU  - Cha SI
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Park, Jae Yong
AU  - Park JY
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.
FAU - Kim, Chang Ho
AU  - Kim CH
AD  - Department of Internal Medicine, Kyungpook National University School of
      Medicine, Daegu, South Korea.. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170411
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
RN  - 0 (Biomarkers)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/analysis
MH  - Case-Control Studies
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*complications
MH  - Pleural Effusion, Malignant/*complications/*diagnosis/drug therapy
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Tuberculosis, Pleural/*complications/*diagnosis/drug therapy
OTO - NOTNLM
OT  - Cancer
OT  - Malignant pleural effusion
OT  - Pleural effusion
OT  - Tuberculous pleural effusion
EDAT- 2017/09/03 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/09/03 06:00
PHST- 2017/01/27 [received]
PHST- 2017/03/27 [revised]
PHST- 2017/04/07 [accepted]
AID - S0002-9629(17)30212-4 [pii]
AID - 10.1016/j.amjms.2017.04.006 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 Aug;354(2):125-130. doi: 10.1016/j.amjms.2017.04.006. Epub
      2017 Apr 11.