Pleural effusion diagnosis method consists of checking the general characteristics (color, transparency, pH, specific gravity, and coagulation), biochemical tests (quantitative and qualitative protein, glucose, trace elements, etc.), bacteriological examination. Through these checks can be leakage of fluid or a judge ascites effusion, ascites, the nature of the initial discrimination.
Pleural effusion diagnosis method (a) of the serum ascites from protein gradient
Serum ascites albumin gradient (SAAG) and serum albumin is measured over the same day, the difference between ascites albumin. SAAG two to three llg / L prompted ascites due to portal hypertension, SAAG <llg / L, compared with non-portal hypertensive ascites. Ascites caused by various reasons, the analysis found, SAAG ascites etiology of the diagnostic accuracy is much higher than the ascites total protein (AFTP) definition of permeability, leakage of fluid concept, both were 92% -100% and 56 % -76%.
Some scholars believe that SAAG <llg / L diagnosis of peritoneal malignancy with a sensitivity of 62% -93%, a specificity of 98% – 99% of the total effective rate was 90%. Produce low SAAG ascites of malignant tumor cells is due to release of vasoactive substances to vascular permeability increase in peritoneal surface, more the amount of the protein into the abdominal cavity caused by the gap. In addition, tuberculous peritonitis, membrane-derived ascites, biliary ascites, also can be expressed as a SAAG <llg / L. Recent studies have shown that tuberculous peritonitis, and malignant ascites were significantly different between the SAAG, the former (4.62 2.2) g / L, which is (7.82 4.1) g / L (P <0.01). But the larger overlap between the two, it has yet to determine the appropriate cutoff.
Diagnosis of pleural effusion method (b) trace element
Trace Elements and tumor development and treatment are closely related. A study of domestic serum copper Note 14. 34mol/24h, ascites copper twenty-three 5.04mol/24h identification as the value of benign and malignant disease, serum copper showed a sensitivity of 81.82%, specificity 84%, the effectiveness of 82.98% ; ascites copper sensitivity 81.82%, specificity 96%, the effectiveness of 89.35%. In addition, serum copper / Cincinnati twenty-three 1.25, ascites copper / Cincinnati twenty-three 1.98 as a reference also has a high differential diagnosis. Serum copper / 77.28% sensitivity and specificity of 72%, the effectiveness of 74.46%; ascites copper / pound sensitivity of 72.74%, specificity 76%, the effectiveness of 74.46%.
Pleural effusion diagnosis methods (c) cholesterol
Ascites cholesterol content of the differential diagnosis of benign and malignant ascites has some significance, usually malignant ascites increased cholesterol levels, if 1.26mmol / L for the critical value (J.26 was negative, two or three positive 1.26) statistics, the negative coincidence rate 95.2% positive consistent rate was 84.2%. Changes in cholesterol levels in ascites mechanism is not entirely clear, may be related to local secretion of tumor tissue.
- saag score in pleural effusion