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M.E. Vázquez-Manríquez
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-019 - Accuracy of Percutaneous Closed Pleural Biopsy in Thoracic Malignancies (ID 54)
09:30 - 09:30 | Author(s): M.E. Vázquez-Manríquez
- Abstract
Background:
Recently there has been some controversy about the value of percutaneous closed pleural biopsy (PCPB) as a diagnostic procedure for establishing the etiology of pleural effusion. Our objective was to assess the accuracy of percutaneous closed pleural biopsy as a diagnostic procedure for lung cancer and mesothelioma in patients with pleural effusion.
Methods:
We performed a prospective study of all individuals who underwent percutaneous closed pleural biopsy, using Cope needle or Abram’s needle in order to establish the etiology of pleural effusion, during a 8/year period in a refering hospital of respiratory diseases in Mexico City. The identification of patients who underwent closed pleural biopsy was obtained from the anatomopathological registries. The information of each patient was obtained by medical record review. In this study, when the pleural biopsy did not establish the definite diagnostic, we used as a gold standard other procedures such as thoracoscopy, open lung/pleural biopsy, fiberoptic bronchoscopy, adenosine deaminase and/or microbiological tests. All cases were followed up at least three months through medical record review and direct contact with the patient. With 2x2 table we determined the accuracy of PCPB.
Results:
A total of 1034 pleural biopsies were performed. Malignancy was identified in 466 (45.07%) of whom 252 (24.37%) had adenocarcinoma,105 (10.16%) mesothelioma, cancer not differentiated 28 (2.71%), epidermoid 5 (0.48%) small cells cancer 19 (1.84%), giant cells cancer 6 (0.58%), limphomas 11 (1.06%) and others malignancies 40 (3.87%). 116 (%) cases of pleural tuberculosis and 2 (0.19%) parapneumonicos. 378 (36.56%) biopsies were non/specific inflammatory. 171 (19.81%) were excluded to the analysis due to 72 (6.96%) obtaining no pleural tissue and in 99 (9.57%) we can not obtain case information. A total of 863 biopsies were analysed to asses the accuracy.Indicator Lung cancer and other malignancies Mesothelioma Sensitivity % (CI 95%) 77 (74-79) 81 (78-83) Specificity % (CI 95%) 98 (97-99) 100 Positive predictive value % (CI 95%) 99 (98-100) 100 Negative predictive value % (CI 95%) 66 (63-70) 97 (96-98) Likelihood ratio positive 38.5 81 Likelihood ratio negative 0.23 0.19 Prevalence % (CI 95%) 68 (65-71.3) 15 (13-17)
Conclusion:
This is a valid, available, accurate and precise diagnostic test which can be applied in patients with pleural effusion to establish cancer or tuberculosis diagnostic. The percutaneous closed pleural biopsy in this setting is useful in our practice due to produces big change from pre-test to post-test probability.
