Pleural fluid biomarkers: a narrative review.

Area of Science:

• Pulmonary Medicine
• Biomarker Analysis
• Diagnostic and Prognostic Tools

Background:

• Pleural fluid analysis offers a valuable source for biomarkers.
• These biomarkers aid in managing and predicting outcomes for various conditions.

Purpose of the Study:

• To review the latest literature on selected pleural fluid biomarker applications.
• To summarize established and emerging uses of pleural fluid biomarkers.

Main Methods:

• A comprehensive literature search was conducted via PubMed (January 2000 - December 2023).
• Included prospective and retrospective cohort studies analyzing the clinical value of pleural fluid biomarkers.
• Author judgment was used to include additional relevant references.

Main Results:

• Adenosine deaminase, mesothelin, and N-terminal pro-B-type natriuretic peptide optimize diagnosis for tuberculous pleuritis, mesothelioma, and heart failure effusions.
• Pleural fluid EGFR mutation detection is superior to tissue or plasma for lung cancer, guiding targeted therapy.
• Neutrophil-lymphocyte ratio, soluble urokinase plasminogen activator receptor, and plasminogen activator inhibitor 1 offer prognostic insights.

Conclusions:

• Pleural fluid biomarkers have established or promising clinical applications.
• Further research is essential to expand the range and improve the utility of these biomarkers.
• Comparative studies with serum biomarkers and radiological findings are recommended.