Pleural fluid and serum amylase ratio for differentiation between malignant and tuberculous pleural effusion
Journal Title: PARIPEX-Indian Journal of Research - Year 2017, Vol 6, Issue 4
Abstract
Original article Pleural fluid and serum amylase ratio for differentiation between malignant and tuberculous pleural effusion. Background: Pleural effusion provide the opportunity to diagnose the disease causing the effusion with analysis of fluid obtained by thoracentesis, which is "diagnostic" in approximately 75% of patients and useful in management in an additional 15-20% 2. Objective: The present study is planned to estimate pleural fluid and serum amylase levels and their ratio in cases of exudative pleural effusions and its role in differentiating malignant from tuberculous pleural effusion. Study design: A prospective observational study was conducted on 63 patients of exudative pleural effusion, admitted in various medical wards with the diagnosis of 33 as tubercular and 30 as malignant effusion, in a tertiary care teaching hospital in western Rajasthan, India. Methodology: After detailed history and through clinical examination cases of pleural effusion from February 2009 to January 2011 were taken in the study to establish etiological diagnosis. Pleural fluid was collected after thoracocentesis and sent for cytological and biochemical testing including amylase. Serum amylase was also measured to estimate the ratio of pleural fluid and serum amylase. Results: In this prospective observational study 63 patients were enrolled, 33 patients are of tubercular and 30 were of malignant effusion. The pleural fluid/serum amylase ration ranging from 0.93 to 3.11 with the mean of 1.48±0.43 in malignant pleural effusion, whereas this ratio was ranging from 0.41 to 1.07 with the mean of 0.70±0.19 in tuberculous pleural effusion (p<0.001). The pleural fluid/serum amylase ratio was more than one in ( 96.66%) patients of malignant pleural effusion. The pleural fluid/serum amylase ratio was less than one in (96.96%), patients of tuberculous pleural effusion. Conclusion: The pleural fluid amylase was more than 200 SU/dl and pleural fluid/serum amylase ratio was more than one in malignant pleural effusion. Whereas these values were lower, (pleural fluid amylase less than 200 and pleural fluid/serum amylase ration less than one), in tuberculous pleural effusion.
Authors and Affiliations
Rajesh Chetiwal, R. K. Bhimwal
Keywords
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