Retrospective Analysis Of Diagnostic Methods Of Malignant Pleural Effusion

Objective To analyze the clinical diagnostic characteristics ofmalignant pleural effusion, and research for better methods to discoveryand diagnose malignant pleural effusion at an early date.Methods168cases inpatients’ clinical data of malignant pleuraleffusion of our hospital were analyzed retrospectively from2008to2011.Results147cases inpatients performed thoracocentesis andunderwent Tunnelled indwelling pleural catheters (TIPC) insertion withultrasonographic guidance,of which15cases underwent cytologicexamination many times,130cases malignant cells are found in pleuralfuid on cytologic examination, with a detection rate of88.4%;54casesunderwent pleural biopsy via Video-assisted thoracoscopic (VATS), witha disease detection positive rate of98.2%;3cases underwent pleuralbiopsy via Ultrasound guided percutaneous puncture, and3cases fondmalignant cells in the pleural tissue, with a disease detection positive rateof100%;1cases underwent CT-guided percutaneous lung puncture biopsy,with a detection positive rate; cervical lymph node biopsy1cases, alsowith a detection positive rate;1case underwent supraclavicular fossalymph node biopsy, with a diagnosis of lung metastatic squamous adenocarcinoma. Pathological diagnosis by immunohistochemistry identifyprimary disease of malignant pleural effusion41cases, of which2caseshas no clear etiology diagnosis, need to do further checks clear.Pleuraleffusion and serum CEA ratio was significantly higher than that of asingle CEAdetection rate.Conclusion To performe thoracocentesis and underwent Tunnelledindwelling pleural catheters (TIPC) insertion with ultrasonographicguidance, microtubules drainage of pleural effusion,and underwentpleural fluid cytology examination several times, can improve thepositive rate of diagnosis of malignant pleural effusion, it’s safe, effective,and easy for patients to accept. Video-assisted thoracoscopic (VATS) isthe optimal inspection method, which is clinically used for the diagnosisof suspected malignant pleural effusion, it’s positive diagnosis rate ishigher than that of hydrothorax exfoliative cytology, safe, minimallyinvasive, less complication, worthy of popularization and promotion. It isworthy of clinical application. CT or B ultrasound guided percutaneousclosed pleural biopsy and lymph node biopsy can increase the successrate, and of more safer diagnosis there is important significance onetiological diagnosis of malignant pleural effusion. Immunohistochemicaltechnique was applied to pathological diagnosis, which facilitatesidentification of the primary lesion and identification of etiologicdiagnosis. Pleural effusion and serum CEA ratio was significantly higher than that of a single CEAdetection rate, which is more meaningful for thediagnosis of malignant pleural effusion.