Cancer Ratio,Pleural Fluid Adenosine Deaminase,Lactate Dehydrogenase, interferonY, Tumor Necrosis Factor,and Interleukins{2,12,18}for Differentiation Between Malignant and Non Malignant Pleural Effusion

Study Overview
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Brief Summary
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To evaluate the ability of cancer ratio and pleural fluid markers to discriminate between malignant and non malignant effusion

Detailed Description
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Pleural effusion is a common clinical entity affecting approximately 1.5 million patients per year in the United States. {3.1}A large number of diseases may be associated with pleural effusion. This includes: Local conditions affecting the pleura (eg, tuberculous pleurisy, pleural mesothelioma), Extrapulmonary diseases with secondary pleural involvement (eg, chronic heart failure, liver cirrhosis). To date, differentiation between both types of pleural effusion (exudate and transudate) is the most common initial diagnostic approach for patients with pleural effusion. Exudative effusion is commonly seen in three conditions namely cancer (MPE), tuberculosis (TB) and para pneumonic Although MPE can be diagnosed by simple pleural fluid cytology, this method has significant limitations, including a highly variable sensitivity, ranging from as low as 11.6% to as high as 71%. In contrast to other common causes of pleural effusion such as T.B, no accurate biomarkers of MPE have been established. Several tumor markers were extensively evaluated, including carcinoembryonic antigen, cytokeratin-19 fragments, and cancer antigen 125, but none of them were found sensitive and specific enough to be implemented in routine clinical practice

Official Title
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Cancer Ratio,Pleural Fluid Adenosine Deaminase,Lactate Dehydrogenase, interferonY, Tumor Necrosis Factor,and Interleukins{2,12,18}for Differentiation Between Malignant and Non Malignant Pleural Effusion

Conditions
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Pleural Effusion, Malignant

Intervention / Treatment
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* Diagnostic Test: pleural markers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients (100 cases) with exudative pleural effusion who will be admitted to Department of Chest diseases and Tuberculosis, Assiut University Hospital Exclusion Criteria: Age ˂ 18 years Refusal to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: pleural markers|Pleural Fluid Adenosine Deaminase,Lactate Dehydrogenase, interferonY, Tumor Necrosis Factor,and Interleukins{2,12,18}|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differentiate between malignant and non malignant pleural effusion by pleural markers | using pleural markers | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time saving | decrease the need for invasive maneuvers for diagnosis decrease length of hospital stay decrease the development of complications | Baseline |