Diagnostic Evaluation of Malignant Pleural Effusion by incorporating Medical Thoracoscopy and Confirmation by Histopathology taken as Gold Standard
Ajmaal Jami, Amanullah Khokhar, Mahnoor Khalil, Aneela Qureshi, Sumayya Khan, Rekha Melwani
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Abstract
Objective: To determine the diagnostic accuracy of medical thoracoscopy for detection of malignant pleural effusion, histopathology findings were taken as gold standard.
Study Design: Retrospective/Observational
Place and Duration: Tertiary Care hospitals in Karachi for period of 6 months from 6th March 2020 to 6th August 2020.
Methodology: One hundred and fifteen patients of both genders clinically diagnosed to have malignant pleural effusions were enrolled in this study. Patients ages were ranging from 25 to 70 years. After taking written consent, detailed demographics including age, sex, BMI and comorbidities were recorded. All patients underwent medical thoracoscopy. Biopsies were performed and samples went to laboratory for histopathological examination. Diagnostic accuracy, PPV, NPV, sensitivity and specificity of thoracoscopy were examined. Data was analyzed by SPSS 27.0.
Results: Out of 115 patients, 72 (62.61%) were males while 43 (37.39%) were females. Mean age was 52.46±10.82 years. Majority 60 (52.17%) patients were ages between 46 to 55 years. 85 (73.91%) patients had malignant pleural effusions by thoracoscopy while by histopathology 93 (80.87%) patients had malignant pleural effusions. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of medical thoracoscopy were 91.40%, 100%, 100%, 73.33% and 93.04%.
Conclusion: It is concluded that medical thoracoscopy is safe and effective procedure for diagnosing malignant thoracoscopy with acceptable diagnostic accuracy rate.
Keywords: Malignant Pleural Effusions, Thoracoscopy, Diagnostic Accuracy