Heparan sulfate chains contribute to the anticoagulant milieu in malignant pleural effusion

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 143-152 ◽  
Author(s):  
Emilia Hardak ◽  
Eli Peled ◽  
Yonatan Crispel ◽  
Shourouk Ghanem ◽  
Judith Attias ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Pleural Effusion ◽  
Heparan Sulfate ◽  
Tumour Cell ◽  
Malignant Pleural Effusion ◽  
Pleural Cavity ◽  
Therapeutic Option ◽  
Factor Xa ◽  
Pleural Effusions ◽  
Cell Proliferation Inhibition

BackgroundWhile malignant pleural effusion (MPE) is a common and significant cause of morbidity in patients with cancer, current treatment options are limited. Human heparanase, involved in angiogenesis and metastasis, cleaves heparan sulfate (HS) side chains on the cell surface.AimsTo explore the coagulation milieu in MPE and infectious pleural effusion (IPE) focusing on the involvement of heparanase.MethodsSamples of 30 patients with MPE and 44 patients with IPE were evaluated in comparison to those of 33 patients with transudate pleural effusions, using heparanase ELISA, heparanase procoagulant activity assay, thrombin and factor Xa chromogenic assays and thromboelastography. A cell proliferation assay was performed. EMT-6 breast cancer cells were injected to the pleural cavity of mice. A peptide inhibiting heparanase activity was administered subcutaneously.ResultsLevels of heparanase, factor Xa and thrombin were significantly higher in exudate than transudate. Thromboelastography detected almost no thrombus formation in the whole blood, mainly on MPE addition. This effect was completely reversed by bacterial heparinase. Direct measurement revealed high levels of HS chains in pleural effusions. Higher proliferation was observed in tumour cell lines incubated with exudate than with transudate and it was reduced when bacterial heparinase was added. The tumour size in the pleural cavity of mice treated with the heparanase inhibitor were significantly smaller compared with control (p=0.005).ConclusionsHS chains released by heparanase form an anticoagulant milieu in MPE, preventing local thrombosis and enabling tumour cell proliferation. Inhibition of heparanase might provide a therapeutic option for patients with recurrent MPE.

scholarly journals KARAKTERISTIK PASIEN EFUSI PLEURA DI KOTA JAMBI

2020 ◽  
Vol 8 (1) ◽  
pp. 54-59
Author(s):  
Hasna Dewi ◽  
Fairuz Fairuz
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Inflammatory Process ◽  
Pleural Cavity ◽  
Descriptive Study ◽  
Primary Data ◽  
Pleural Effusions ◽  
Cytological Examination ◽  
Male Sex ◽  
The Right

ABSTRACT Introduction Pleural effusion is a condition where the fluid either a transudate or an exudate accumulate in pleural cavity. Disease that can cause pleural effusion can be either a malignancy or an inflammatory process. Intratoracal and extratoracal malignancies can cause pleural effusion (malignant pleural effusion / MPE). The aim of this study was to describe the characteristics of patients with pleural effusion and the proportion of malignant pleural effusion in Jambi City. Methods This research is a descriptive study with a retrospective approach, was conducted in 138 sample of pleural effusion patients at two hospital Raden Mattaher and H. Abdul Manap Hospital in 2017-2018. The data was taken from the patient's medical record and primary data in the form of cytological examination results. Results of this study found that most patients with pleural effusion were at the age 40 - 59 years (52.72%), and more men than women (63.77%). The location of the most common effusion was the right hemithorax (52.9%) and the proportion of malignant pleural effusion was only 32.61%. Conclusion Pleural effusion often occurs at the age of 40-59 years with male sex predominant. Most pleural effusions are negative for malignancy, MPE was only 32,61 %. Keywords: characteristics, cytology, malignant pleural effusion (MPE)   ABSTRAK Pendahuluan Efusi pleura merupakan keadaan terkumpulnya cairan di dalam rongga pleura, baik itu transudat maupun eksudat. Penyakit yang dapat menyebabkan terjadinya efusi pleura dapat berupa keganasan maupun proses inflamasi. Keganasan intratorakal dan ekstratorakal dapat menimbulkan terjadinya efusi pleura (efusi pleura maligna/EPM). Sampai sekarang belum ada data deskriptif mengenai efusi pleura di kota Jambi. Adapun tujuan penelitian ini mengetahui karakteristik pasien dengan efusi pleura dan proporsi kejadian efusi pleura maligna di Kota Jambi. Metode Penelitian ini adalah penelitian deskritif dengan pendekatan retrospektif. Sampel penelitian merupakan pasien efusi pleura di kota Jambi dari dua RS pemerintah yaitu RSUD Raden Mattaher dan RSUD H. Abdul Manap tahun 2017- 2018 sebanyak 138 sampel. Cara pengambilan sampel dalam penelitan yaitu purposive sampling. Data yang diambil adalah data dari rekam medis pasien dan data primer berupa hasil pemeriksaan sitologi Hasil penelitian ini mendapatkan pasien efusi pleura paling banyak pada proporsi umur 40 – 59 tahun (52,72 %). Jenis kelamin terbanyak adalah laki-laki dengan 88 pasien (63,77%). Lokasi efusi tersering adalah hemithorak dekstra (52,9 %) dan proporsi kejadian efusi pleura maligna hanya 32,61 %. Simpulan Efusi pleura sering terjadi pada usia 40-59 tahun dengan jenis kelamin laki-laki. Sebagian besar efusi pleura adalah negatif maligna, hanya 32,61 % berupa EPM. Kata kunci: efusi pleura maligna (EPM), karakteristik, sitologi

Pleural tumours

2010 ◽  
pp. 3534-3539
Author(s):  
Robert J.O. Davies ◽  
Y.C. Gary Lee
Keyword(s):  
Pleural Effusion ◽  
Case History ◽  
Pleural Cavity ◽  
Solitary Fibrous Tumour ◽  
Pleural Effusions ◽  
Old Chinese ◽  
Benign Tumours

Case History—A 54 yr old Asian man, and a 19 yr old Chinese man, both with pleural effusions. Case History—A 68 yr old man with a pleural effusion. Benign tumours are rare in the pleural cavity, with solitary fibrous tumour of the pleura, the most frequent of these rarities....

scholarly journals Administration of the adriamycin-containing poly (L-lactic acid) microspheres into the pleural cavity of patients with malignant pleural effusion.

1990 ◽  
Vol 5 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Osamu Ihe ◽  
Shigeki Hitomi ◽  
Yasuhiko Shimizu ◽  
Ryoichi Wada ◽  
Satoshi Watanabe ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Pleural Cavity

scholarly journals Prolonged retention of liposomes in the pleural cavity of normal mice and high tumor distribution in mice with malignant pleural effusion, after intrapleural injection

2019 ◽  
Vol Volume 14 ◽  
pp. 3773-3784 ◽  
Author(s):  
Antonia Marazioti ◽  
Konstantina Papadia ◽  
Anastasios Giannou ◽  
Georgios T. Stathopoulos ◽  
Sophia Antimisiaris
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Pleural Cavity ◽  
Prolonged Retention ◽  
Tumor Distribution

scholarly journals PAI-1 Level Differences in Malignant Plural Effusion, Parapneumonic Pleuritis, and Cardiac Hydrothorax

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 567
Author(s):  
Zentina ◽  
Stukena ◽  
Krams ◽  
Lejnieks
Keyword(s):  
Pleural Effusion ◽  
Fibrinolytic Activity ◽  
Malignant Pleural Effusion ◽  
Clinical Manifestations ◽  
Plasminogen Activator Inhibitor ◽  
Pleural Effusions ◽  
Plasminogen Activator Inhibitor 1 ◽  
Significant Difference ◽  
Activator Inhibitor ◽  
Pai 1

Background and Objectives: Plasminogen activator inhibitor-1 (PAI-1) is a fibrinolytic system enzyme whose role in various fibrinolytic processes is currently unknown. In clinical manifestations of pleural liquids of diverse etiology, various levels of fibrinolytic activity can be observed—parapneumonic processes tend to loculate in fibrin septa, while malignant pleural effusion (MPE) does not. The purpose of this study was to determine possible differences in PAI-1 levels in pleural effusions of varied etiology. Material and Methods: PAI-1 level in pleural effusion and serum was determined in 144 patients with pleural effusions of various etiology (cardiac hydrothorax—42 patients (29.2%), MPE—67 patients (46.5%), parapneumonic pleuritis—27 (18.8%), tuberculous pleuritis—6 patients (4.1%), pancreatogenic pleuritis—1 patient (0.7%) and pulmonary artery thromboembolism with pleuritis—1 patient (0.7%)). Results: The median PAI-1 level (ng/mL) was the highest in the parapneumonic pleuritis group both in the effusion and the serum, with values of 291 (213–499) ng/mL and 204 (151–412) ng/mL, respectively, resulting in a statistically significant difference (p < 0.001) from the cardiac hydrothorax and MPE groups. However, there was no statistically significant difference between PAI-1 levels in the pleural effusion and serum in the cardiac hydrothorax and MPE groups. Conclusion: The PAI-1 level in MPE and cardiac hydrothorax was statistically significantly lower than in parapneumonic pleuritis.

Suspicious for Malignancy Diagnoses on Pleural Effusion Cytology

2020 ◽  
Vol 154 (3) ◽  
pp. 394-402
Author(s):  
Erika F Rodriguez ◽  
Ricardo G Pastorello ◽  
Paul Morris ◽  
Mauro Saieg ◽  
Sayanan Chowsilpa ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Sample Volume ◽  
Definitive Diagnosis ◽  
Cell Tumor ◽  
Pleural Effusions ◽  
Not Otherwise Specified ◽  
Significant Difference ◽  
Pathology Reports ◽  
Average Sample

Abstract Objectives A definitive diagnosis of malignancy may not be possible in pleural effusions. We report our experience with the diagnosis of suspicious for malignancy (SFM) in pleural effusion. Methods A search for pleural effusions diagnosed as SFM (2008-2018) was performed. Patient records and pathology reports were reviewed. Specimens were subdivided into groups depending on volume (&lt;75, 75-400, &gt;400 mL). Diagnoses of malignant pleural effusion (MPE) served as controls. Results We identified 90 patients, with a mean age of 60.6 years. Diagnoses included suspicious for involvement by carcinoma/adenocarcinoma in 64.4%, leukemia/lymphoma in 15.6%, melanoma in 2.2%, sarcoma in 3.3%, germ cell tumor in 1.1%, and not otherwise specified in 13.3%. Immunostains were performed in 47.8% and considered inconclusive in 24%. Average sample volume was 419 mL. There was a statistically significant difference between the SFM vs MPE groups for volumes greater than 75 mL (P = .001, χ 2 test), with SFM having increased proportion of volumes  greater than 400 mL, compared with the MPE group. There was no statistically significant difference in mean overall survival when the groups were compared (P = .49). Conclusions Samples with low cellularity, scant cell blocks, and inconclusive immunostains may contribute to a suspicious category diagnosis in pleural effusions.

THERAPIES OF RESISTANT EXUDATIVE PLEURITIS

2020 ◽  
pp. 22-30
Author(s):  
A.L. Charyshkin ◽  
E.A. Kuzmina ◽  
B.I. Khusnutdinov ◽  
E.A. Toneev ◽  
O.V. Midlenko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Ovarian Cancer ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Malignant Neoplasms ◽  
Risk Of Infection ◽  
Minimally Invasive Methods

In Russia, annually more than 100,000 people are diagnosed with tumor pleuritis. Resistant cancerous pleuritis is often caused by lung cancer (35 %), breast cancer (23 %), ovarian cancer and lymphomas (10 %). Pleuritis in malignant neoplasms often indicates the spread of the process through pleura. At the same time, systemic therapy does not always help patients. Radical treatment for malignant pleural effusion is gradually being replaced by new minimally invasive methods. Prolonged drainage of the pleural cavity in exudative pleuritis increases the risk of infection, which contributes to the development of pleural empyema. In order to eliminate the exudate, talc, tetracycline, and Betadine solutions are introduced into the pleural cavity through the drainage, the efficacy being 60 to 90 %. Thus, a new method for drug administration into the pleural cavity, which helps to eliminate resistant exudative pleuritis, remains relevant. Keywords: resistant exudative pleuriris, malignant neoplasms, pleurodesis. Проведен обзор отечественной и зарубежной литературы, посвященный местному лечению резистентного злокачественного плеврита. С каждым годом частота онкологических заболеваний и опухолевых плевритов только повышается. В России ежегодно опухолевые плевриты диагностируют более чем у 100 000 чел. Резистентный злокачественный плеврит в 35 % случаев обусловлен раком легкого, в 23 % – раком молочной железы, в 10 % – раком яичников и лимфомами. Плеврит при злокачественных новообразованиях часто свидетельствует о распространении процесса по плевре. При этом использование системных методов лечения не всегда облегчает состояние пациента. Радикальные методы лечения злокачественного плеврального выпота постепенно заменяются новыми минимально инвазивными методами. Продолжительное дренирование плевральной полости при экссудативном плеврите увеличивает риск ее инфицирования, что способствует развитию эмпиемы плевры. С целью ликвидации экссудата через установленный дренаж в плевральную полость вводят растворы талька, тетрациклина, бетадина с эффективностью от 60 до 90 %. Недостатком данного способа лечения является выраженный болевой синдром, повышение температуры тела, риск легочных осложнений, длительность лечения. Таким образом, создание способа введения лекарственных препаратов в плевральную полость для ликвидации резистентного экссудативного плеврита остается актуальным. Ключевые слова: резистентный экссудативный плеврит, злокачественные новообразования, плевродез.

scholarly journals Novel pleural-bladder pump in malignant pleural effusions: from animal model to man

Thorax ◽  
2020 ◽  
Vol 75 (5) ◽  
pp. 432-434 ◽  
Author(s):  
Philippe Astoul ◽  
Sophie Laroumagne ◽  
Jeroen Capel ◽  
Nicholas A Maskell
Keyword(s):  
Quality Of Life ◽  
Animal Model ◽  
Pleural Effusion ◽  
Management Strategy ◽  
Malignant Pleural Effusion ◽  
Pleural Space ◽  
Optimal Management ◽  
Pleural Effusions ◽  
Pump System

Malignant pleural effusion is common and causes disabling symptoms such as breathlessness. Treatments are palliative and centred around improving symptoms and quality of life but an optimal management strategy is yet to be universally agreed. A novel pump system, allowing fluid to be moved from the pleural space to the urinary bladder, may have a role for the management of recurrent malignant pleural effusion. We hereby describe the first animal study using this device and the results of the first application in patients.

scholarly journals CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Tianyu Zhang ◽  
Cuicui Wu ◽  
Zhongtao Li ◽  
Yan Ding ◽  
Lijuan Wen ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Energy Spectrum ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Statistical Significance ◽  
High Energy ◽  
Diagnostic Methods ◽  
Pleural Effusions ◽  
Multiple Parameters ◽  
Spectrum Curve

The emergence of energy spectrum CT provides greater diagnostic value for clinical practice. Its advantage is that it can provide more functional imaging parameters and accurate image information for clinical practice, which represents a mainstream direction of CT technology development at present. This paper mainly studies the clinical trial of CAMPO Precision128 Max ENERGY spectrum CT combined with multiple parameters to evaluate the benign and malignant pleural effusion. This paper analyzes the principle and key performance parameters of energy spectrum CT imaging, the etiology of pleural effusion, and its conventional diagnostic methods and uses energy spectrum CT to detect the benign and malignant pleural effusion. In this paper, two groups of patients with different types of pleural effusions were scanned by line spectrum chest CT scans, and energy spectrum analysis software was used to measure and calculate the CT values of conventional mixed energy values of ROI of patients with pleural effusions. For the CT value and energy curve slope measurement value of different single energy keV, independent sample t-test was used to analyze and compare the two sets of data, and finally it has been found out that the two sets of data were similar. According to the experimental results, the curves of energy spectrum of the two groups of data are similar in the descending curve of bow-back. The slope of energy spectrum curve in the leakage group was lower than that in the exudate group, showing statistical significance ( P < 0.05 ). The slope of energy spectrum curve K in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group, and the difference was statistically significant ( P < 0.05 ). The trend of energy spectrum curves of the two is roughly the same, while at the high energy level, part of the energy spectrum curves of the two are overlapped. The above conclusion indicates that energy spectrum CT plays a certain role in the differential diagnosis of pleural effusion. At the same time, energy spectrum CT also provides a noninvasive and rapid examination method for clinical differentiation of pleural effusion, which has certain clinical application value and prospect.

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