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Pleural ELFA D-dimer assay: a surrogate marker for malignant pleural effusion
Alona Matveychuk1, Gloria Rashid, Ziva Fridman
1Pulmonary Department, Meir Medical Center, Kfar Saba, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Thrombosis Research
|August 30, 2011
Summary
High D-dimer levels in pleural fluid indicate malignancy. The pleural D-dimer assay is a valuable, noninvasive tool for predicting malignant pleural effusion, offering significant diagnostic potential.
Area of Science:
- Pulmonary Medicine
- Oncology
- Clinical Chemistry
Background:
- Malignant pleural effusion is linked to increased fibrinolysis.
- Limited data exist on the diagnostic utility of pleural D-dimer assays.
- This study investigated the role of pleural D-dimer in predicting malignant pleural effusion.
Purpose of the Study:
- To assess the diagnostic accuracy of pleural D-dimer assay for malignant pleural effusion.
- To evaluate D-dimer as a potential noninvasive marker for malignancy in pleural fluid.
Main Methods:
- Prospective laboratory investigation of 103 patients with pleural effusion.
- Measurement of blood and pleural D-dimer levels using Enzyme Linked Fluorescent assay (ELFA).
- Correlation of D-dimer results with clinical, laboratory, radiological findings, and final diagnosis.
Main Results:
- Pleural D-dimer levels showed a significant positive correlation with malignant pleural effusion (p=0.0001).
- Pleural D-dimer assay was the sole significant predictor of malignant pleural effusion in logistic regression (OR 1.007, p=0.007).
- The assay achieved an area under the ROC curve of 0.79, with 82% sensitivity and 74% specificity at 146mg/ml.
Conclusions:
- Elevated D-dimer levels are characteristic of malignant pleural effusion.
- Pleural D-dimer assay shows promise as a simple, noninvasive surrogate marker for diagnosing malignant pleural effusion.
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01:25Pleural Effusion I: Introduction
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
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01:28Pleural Effusion II: Symptoms and Management
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations: