GIÁ TRỊ CHẨN ĐOÁN CỦA XÉT NGHIỆM TẾ BÀO HỌC DỊCH MÀNG PHỔI VÀ SINH THIẾT MÀNG PHỔI MÙ Ở BỆNH NHÂN TRÀN DỊCH MÀNG PHỔI ÁC TÍNH

Abstract

Objective: To determine the sensitivity and specificity of cytological examination of the pleural fluid and blind Abrams' needle pleural biopsy in diagnosing malignant pleural effusion. Subject  and  methods: We retrospectively assessed medical records of patients who with malignant pleural effusion and pleural effusion from other causes at Pham Ngoc Thach Hospital from January 2017 to July 2019. Results: Cytological examination of the pleural fluid has a sensitivity of 30.3% and specificity of 98.9% in diagnosing malignant pleural effusion. Subsequent examinations beyond the second one do not have statistically significant significance in diagnosing malignant pleural effusion with p > 0.05. The second examination in patients with malignant cells in the first examination has statistically significant value with p < 0.05. Blind Abrams' needle pleural biopsy has a sensitivity of 21.7% and specificity of 100%. Subsequent examinations beyond the second one do not have statistically significant significance in diagnosing malignant pleural effusion with p > 0.05. The combination of cell examination and blind Abrams' needle pleural biopsy increases the diagnostic capability to 57.4% and the definitive diagnosis to 52.8%. Conclusion: Cytopathology and blind Abrams' needle pleural biopsy still hold value in diagnosing malignant pleural effusion. Only one blind Abrams' needle pleural biopsy should be performed in the diagnosis of malignant pleural effusion. Only one cytopathology should be performed if the initial result is benign and if the initial cytopathology shows malignancy, a repeat examination should be conducted for definitive diagnosis. It is recommended to combine the two methods of pleural fluid cytopathology and blind Abrams' needle pleural biopsy in diagnosing malignant pleural effusion.