Enhanced diagnostic approaches for malignant pleural effusions: an extensive biochemical and statistical analysis

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Introduction: Malignant pleural effusions are a common and debilitating complication of advanced malignancies, affecting approximately one million patients annually. This condition leads to significant morbidity and a decline in quality of life. Accurate diagnosis and effective management are critical yet challenging due to the overlap in biochemical markers between malignant and benign pleural effusions. Aim: This study evaluates an extended panel of biochemical parameters, including albumin gradient, total protein, cholesterol, pH, glucose, specific gravity, and lactate dehydrogenase (LDH), to enhance diagnostic precision. Materials and methods: In order to achieve this, we conducted a cross-sectional, observational case-control study in order to analyze pleural fluid samples from 151 Bulgarian patients, including 79 with malignant effusions and 72 with benign effusions. Biochemical markers, such as albumin gradient, total protein, cholesterol, lactate dehydrogenase (LDH), pH, glucose, and specific gravity, were measured using advanced clinical chemistry analyzers. Statistical analyses, including Mann-Whitney U tests, t-tests, and Spearman’s rank correlations, were used to identify diagnostic markers. Results: The key findings highlighted the diagnostic value of albumin gradient, total protein, and cholesterol levels, which are strongly associated with malignant effusions. LDH and specific gravity also demonstrated potential as supplementary markers, while pH and glucose measurements showed limited utility in differentiating malignancy. Conclusion: Combining these biochemical parameters enhances the precision of pleural effusion analysis, offering a more robust framework for diagnosing and managing malignant pleural effusions effectively.

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