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Malignant cell count in pleural effusion: A potential indicator of mortality
Celal Satici1, Sinem Nedime Sokucu1, Ibrahim Aras1
1University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology, Istanbul, Turkey.
Background:
The role of malignant cell count in pleural fluid as a potential predictor of survival remains under investigation. This study aims to assess the relationship between malignant cell count in pleural effusion and mortality in patients with malignant pleural effusion (MPE).
Methods:
This retrospective cohort study was conducted at a tertiary referral and research hospital, including treatment-naive patients diagnosed with MPE. Univariate and multivariate Cox regression analyses were employed to identify independent predictors of mortality.
Results:
A total of 63 patients were included in the analysis, with a male predominance (39 males, 61.9 %) and a mean age of 65.7 ± 12.5 years. The majority (76.2 %) of patients had NSCLC. Patients were stratified based on malignant cell count into two groups: those with <1700 cells/2mm² and those with ≥1700 cells/2mm². The two groups were similar in demographics, blood and pleural fluid parameters, and comorbidities. Multivariate Cox regression analysis revealed that male gender (HR: 4.14, 95 % CI: 1.65-10.39), active smoking (HR: 2.99, 95 % CI: 1.25-7.16), and malignant cell count (HR: 0.23, 95 % CI: 0.09-0.56) were independent predictors of mortality.
Conclusions:
Our findings indicate that a malignant cell count of <1700 cells/2mm², male gender and active smoking are independent prognostic factors associated with increased mortality in patients with MPE. Further large-scale prospective studies are necessary to confirm the clinical relevance of cytological malignant cell counts and to explore the viability and functional significance of these cells.
Insights
A lower malignant cell count in pleural fluid (<1700 cells/2mm²) is linked to increased mortality in malignant pleural effusion (MPE) patients. Male gender and active smoking also predict poorer survival.
Area of Science:
- Oncology
- Pulmonology
- Cytopathology
Background:
- The prognostic value of malignant cell count in pleural fluid for survival is not well-established.
- Malignant pleural effusion (MPE) diagnosis requires accurate prognostic indicators.
- This study investigates the association between pleural fluid malignant cell counts and mortality in MPE patients.
Purpose of the Study:
- To evaluate the relationship between malignant cell count in pleural effusion and patient mortality.
- To identify independent predictors of survival in patients diagnosed with MPE.
Main Methods:
- Retrospective cohort study of treatment-naive MPE patients at a tertiary referral hospital.
- Univariate and multivariate Cox regression analyses were used to determine mortality predictors.
- Patients were stratified by malignant cell count (<1700 cells/2mm² vs. ≥1700 cells/2mm²).
Main Results:
- The study included 63 MPE patients (61.9% male, mean age 65.7 years), with NSCLC being the most common diagnosis (76.2%).
- Multivariate analysis identified male gender (HR: 4.14), active smoking (HR: 2.99), and malignant cell count (HR: 0.23) as independent predictors of mortality.
- A malignant cell count <1700 cells/2mm² was associated with increased mortality risk.
Conclusions:
- Malignant cell count <1700 cells/2mm², male gender, and active smoking are independent prognostic factors for increased mortality in MPE.
- These findings highlight the potential clinical relevance of cytological malignant cell counts in MPE prognosis.
- Further prospective studies are needed to validate these results and explore the functional significance of these cells.
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