scholarly journals Diving into the Pleural Fluid: Liquid Biopsy for Metastatic Malignant Pleural Effusions

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2798
Author(s):  
Maria Alba Sorolla ◽  
Anabel Sorolla ◽  
Eva Parisi ◽  
Antonieta Salud ◽  
José M. Porcel
Keyword(s):  
Pleural Fluid ◽  
Liquid Biopsy ◽  
Cell Types ◽  
Circulating Tumor Dna ◽  
Therapeutic Interventions ◽  
Driver Mutations ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Micro Rnas ◽  
Low Sensitivity

Liquid biopsy is emerging as a promising non-invasive diagnostic tool for malignant pleural effusions (MPE) due to the low sensitivity of conventional pleural fluid (PF) cytological examination and the difficulty to obtain tissue biopsies, which are invasive and require procedural skills. Currently, liquid biopsy is increasingly being used for the detection of driver mutations in circulating tumor DNA (ctDNA) from plasma specimens to guide therapeutic interventions. Notably, malignant PF are richer than plasma in tumor-derived products with potential clinical usefulness, such as ctDNA, micro RNAs (miRNAs) and long non-coding RNAs (lncRNAs), and circulating tumor cells (CTC). Tumor-educated cell types, such as platelets and macrophages, have also been added to this diagnostic armamentarium. Herein, we will present an overview of the role of the preceding biomarkers, collectively known as liquid biopsy, in PF samples, as well as the main technical approaches used for their detection and quantitation, including a proper sample processing. Technical limitations of current platforms and future perspectives in the field will also be addressed. Using PF as liquid biopsy shows promise for use in current practice to facilitate the diagnosis and management of metastatic MPE.

Molecular Testing on Pleural Fluid Samples

2019 ◽  
Vol 40 (03) ◽  
pp. 340-346
Author(s):  
Scott Oh ◽  
Reza Ronaghi ◽  
Guoping Cai
Keyword(s):  
Pleural Fluid ◽  
Malignant Disease ◽  
Active Area ◽  
Molecular Testing ◽  
Pleural Effusions ◽  
Therapeutic Implications ◽  
Malignant Pleural Effusions ◽  
Fluid Analysis ◽  
Low Sensitivity ◽  
Common Manifestation

AbstractPleural effusions are a common manifestation of both malignant and nonmalignant diseases. The sampling of pleural fluid helps categorize effusions as transudative or exudative and helps differentiate paramalignant from malignant disease. Accurate pleural fluid analysis is critical to the appropriate staging of cancers with significant prognostic and treatment implications. However, the etiology of pleural effusions remains unclear in a significant number of cases after routine thoracentesis and pleural fluid analysis. For malignant pleural effusions, cytologic evaluation of pleural fluid has a relatively low sensitivity. We describe the evolving field of molecular pleural fluid analysis in the setting of malignant disease as an active area of investigation with both diagnostic and therapeutic implications.

Randomized Trial of Pleural Fluid Drainage Frequency in Patients with Malignant Pleural Effusions. The ASAP Trial

2017 ◽  
Vol 195 (8) ◽  
pp. 1050-1057 ◽  
Author(s):  
Momen M. Wahidi ◽  
Chakravarthy Reddy ◽  
Lonny Yarmus ◽  
David Feller-Kopman ◽  
Ali Musani ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Pleural Fluid ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions

scholarly journals Pleural fluid cell-free DNA integrity index to identify cytologically negative malignant pleural effusions including mesotheliomas

BMC Cancer ◽  
2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Krishna B Sriram ◽  
Vandana Relan ◽  
Belinda E Clarke ◽  
Edwina E Duhig ◽  
Morgan N Windsor ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Dna Integrity ◽  
Pleural Effusions ◽  
Cell Free Dna ◽  
Malignant Pleural Effusions ◽  
Free Dna ◽  
Integrity Index ◽  
Fluid Cell

scholarly journals Medical Chest Drain Insertion – Considerations for a Pleural Service

2020 ◽  
Author(s):  
Ying-Tung Liu ◽  
Zi Wei Goh ◽  
Lutz Beckert
Keyword(s):  
Success Rate ◽  
Pleural Fluid ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Fibrinolytic Therapy ◽  
Chest Drain ◽  
Pleural Effusions ◽  
Talc Pleurodesis ◽  
Malignant Pleural Effusions ◽  
The Right

Abstract Aim: To review local chest drain insertions, the indications, use of fibrinolytics, and the success rate of talc pleurodesis in a tertiary hospital in New Zealand. Methods: This is an observational study of all patients requiring chest drain insertion in the respiratory unit in Christchurch Hospital from January 2015 to December 2016. We analysed patient characteristics, type of drain inserted, and the nature of pleural fluid. We report the success of fibrinolytic therapy for empyema and pleurodesis for malignant pleural effusions. Results: A total of 486 chest drains were inserted for 333 patients, with a median age of 69 years. The majority of patients were male (60%) and 259 drains (53.3%) were inserted on the right. The main indications for chest drain insertion were malignant pleural effusions (50.5%), non-malignant pleural fluid (33.6%) and pneumothorax (17.7%). Most drains inserted were of small caliber; they were 12 French (Fr) (62.4%), central venous catheters to drain the pleural space (14.2%), and indwelling pleural catheters (10.9%). Talc slurry pleurodesis for malignant pleural effusions was used in 40 cases with a success rate of 75%. In the 41 cases of empyema and complicated parapneumonic effusions (CPE), 29 organisms were cultured. The majority of organisms identified were Streptococcus and Staphylococcus species. Fibrinolytics were used in 26 cases (52%) of empyema and CPE. Of the 22 patients who required surgical intervention, only two had prior fibrinolytic therapy for empyema / CPE. Conclusion: Small bore catheters were used in Christchurch in keeping with international guidelines. The success rate of talc slurry pleurodesis and fibrinolytic therapy was in keeping with international experience.

Fibronectin is unsuitable as a tumor marker in pleural effusions.

1989 ◽  
Vol 35 (1) ◽  
pp. 166-168 ◽  
Author(s):  
P Delpuech ◽  
G Desch ◽  
F Fructus
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Tuberculosis ◽  
Diagnostic Accuracy ◽  
Tumor Marker ◽  
Pleural Fluid ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
High Concentrations

Abstract We studied 75 patients with nonmalignant pleural effusions (50 with pneumopathy, 16 with pulmonary tuberculosis, and nine with congestive heart failure) and 33 patients with malignant pleural effusions. We selected 105 mg/L as the most suitable cutoff concentration of fibronectin for distinguishing between the two groups. We found high concentrations of fibronectin in 21 of the 33 patients with malignant pleural fluid but also in 37 of the 75 patients with nonmalignant pleural fluid. Evidently, measuring fibronectin in pleural fluid will not help in differentiating nonmalignant from malignant pleural fluids (diagnostic accuracy: 55%).

Determination of tissue polypeptide-specific antigen in pleural fluid and serum from patients with pleural effusion

1995 ◽  
Vol 10 (3) ◽  
pp. 161-165 ◽  
Author(s):  
V. Villena ◽  
J. Echave-Sustaeta ◽  
A. Lopez-Encuentra ◽  
P. Martin-Escribano ◽  
J. Estenoz-Alfaro ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Specific Antigen ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Cytologic Analysis

As a tool for differentiating malignant and benign pleural effusions, we evaluated the diagnostic value of the assay of tissue polypeptide-specific antigen (TPS) in pleural fluid and serum, and of the pleural fluid TPS/serum TPS ratio in patients with pleural effusion. We studied prospectively 147 consecutive patients who had pleural effusions: 43 malignant pleural effusions and 104 benign pleural effusions. TPS levels were measured by RIA. The sensitivity and specificity of these measurements were: TPS in pleural fluid (cutoff 20,000 U/L): 0.21 and 0.98; TPS in serum (cutoff 300 U/L): 0.31 and 0.96; pleural fluid TPSI serum TPS ratio (cutoff 1200): 0.07 and 0.99. All these values enhanced the sensitivity of cytologic analysis of pleural fluid. However, we conclude that TPS assay in pleural fluid and serum, and the pleural fluid TPSI serum TPS ratio have limited diagnostic value in patients with pleural effusion.

Diagnostic Utility of Pleural Fluid CEA and CYFRA 21-1 for Malignant Pleural Effusions

2004 ◽  
Vol 57 (1) ◽  
pp. 32
Author(s):  
Jae Ho Chung ◽  
Jeong Eun Choi ◽  
Moo Suk Park ◽  
Sang Yon Hwang ◽  
Jin Wook Moon ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Diagnostic Utility ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions
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