Clinical Features Of 277 Cases With Benign And Malignant Pleural Effusion

Objective:To clarify the differential diagnosis of pleural effusion by analysing the clinical features of benign and malignant pleural effusion.Methods:Clinical data of 277 patients with clinically diagnosed pleural effusion was retrospectively analyzed.The patient was admitted to guilin medical university affiliated hospital from October 2009 to December 2013 and was followed up to September 30,2015.277 cases of effective follow-up patients were analyzed for clinical characteristics of benign and malignant pleural effusion.The main outcome measures are Clinical symptoms and regular biochemistry of pleural and blood.Results:(1)Cancer cell in pleural effusion was the golden standard for diagnosing malignant or benign pleural effusion,malignant pleural effusion carried cancer cells.All the 277 cases of pleural effusion were divided into a benign pleural effusion group(235cases,84.84%)and a malignant pleural effusion group(42cases,15.16%).The main clinical manifestations were fever,cough,expectoration,chest pain and shortness of breath.The detection rates of chest pain and shortness of breath in the malignant pleural effusion group were significantly higher than those in the benign pleural effusion group,the detection rate off ever was significantly decreased,and the differences between benign and malignant pleural effusion were statistically significant(P<0.001 or P<0.05).Comparing the detection rate of bilateral respiratory motility and the measurements of liver function alanine aminotransferase between benign and malignant pleural effusion groups showed that there were statistically significant differences(P <0.05).(3)Compared to the patient with benign pleural effusion,pleural friction fremitus,vocal fremitus,sound quality of percussion,dry rale and wet rale,blood routine,myocardial enzyme,lactic dehydrogenase and other biochemical indexes had no significant changes in the malignant pleural effusion.Conclusions:1.Some indexes have clinical values in the identification of benign and malignant pleural effusion,including fever,chest pain,shortness of breath,bilateral respiratory motility degree and alanine aminotransferase.2.There is a negative correlation between fever and malignant pleural effusions.In patients with pleural effusion,the risk of malignant pleural effusion decreased by 83.3% compared with those with no fever.