Anugraha, H (2020) Evaluation of Cancer Ratio and Cancer Ratio plus in Identifying Malignant Effusion from Other Exudative Effusions: A Prospective study. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: The most common causes of exudative effusions are Tuberculosis, Cancer and Parapneumonic effusion. Pleural fluid ADA is used as biochemical marker for Tuberculosis. However, there is no reliable biomarker to aid the diagnosis of malignant effusion. We analyze the newly emerging biochemical markers, Serum LDH: Pleural fluid ADA (Cancer ratio) and Cancer ratio plus (Cancer ratio: Pleural fluid lymphocyte count) as predictor of malignant effusion and study its utility. AIM OF THE STUDY: To study the diagnostic potential of Cancer ratio and Cancer ratio plus in identifying malignant effusion from other exudative effusions. METHODOLOGY: Prospective analysis of 102 patients with pleural effusion done. Thorough clinical examination, radiological investigations, routine serum and pleural fluid biochemical analysis are done on the day of admission. Serum LDH, Pleural fluid ADA and lymphocyte count along with other values are noted. Cancer ratio, Cancer ratio plus calculated and patients are prospectively followed up. It is correlated with the final diagnosis and statistically analysed. RESULTS: Cancer ratio and cancer ratio plus is significantly higher in malignant effusion. In multivariate logistic regression analysis, cancer ratio and cancer ratio plus are correlated positively with malignant pleural effusion. Cancer ratio, at cut-off level of 20 showed Sensitivity 94.1% & Specificity 98.3%, cancer ratio plus cut-off level 30 has Sensitivity 94.1% & Specificity 95.6%. CONCLUSION: Cancer ratio and Cancer ratio plus can be calculated from routine biochemical tests, is cost effective and can prompt malignancy with high accuracy. It can guide physicians to look for malignancy more actively than watchful waiting or TB treatment empirically.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201727051 |
| Uncontrolled Keywords: | cancer ratio, cancer ratio plus, malignant pleural effusion, pleural fluid ADA, serum LDH. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 15:56 |
| Last Modified: | 04 Feb 2021 15:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13804 |
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