Work

Integrating pleural fluid and peripheral blood biomarkers to improve malignant vs. tuberculous pleural effusion diagnosis: a retrospective study

Year: 2026

Type: article

Abstract: Accurate differentiation between malignant pleural effusion (MPE) and tuberculous pleural effusion (TPE) remains a critical clinical challenge, attributed to the suboptimal sensitivity of pleural effusion (PE) cytology for MPE and low microbiological positivity rate for TPE. This study evaluated the diagnostic value of individual and combined biomarkers derived from PE and peripheral blood (PB) to assist in the clinical differential diagnosis of MPE and TPE. This retrospective study included 290 patients (102 MPE, 188 TPE). Clinical and laboratory data were retrieved from electronic medical records (EMRs). Diagnostic performance of 18 individual and 74 combined biomarkers was assessed via ROC curve analysis. MPE patients were older (median 69 vs. 53 years, p < 0.001) with more females (57% vs. 29%, p < 0.001). PE-CEA showed the best single-biomarker performance (AUC = 0.95, 95% CI: 0.91–0.98), followed by PB-CYFRA21-1 (AUC = 0.91) and PB-CEA (AUC = 0.90). Eight combined biomarkers outperformed PE-CEA; PE-SPOT/PE-CEA had the highest AUC (0.98, 95% CI: 0.96–0.99). Combined PE and PB biomarker ratios show promising preliminary diagnostic potential for MPE-TPE differentiation. PE-CEA is optimal alone, PE-SPOT/PE-CEA is the best combination. These findings could inform future validation studies of stratified diagnostic approaches.

Source: BMC Pulmonary Medicine

DOI: 10.1186/s12890-026-04634-z

Authors: Shanling Yu, Feifei Liu, Qi Tian, Shufeng Xu, Chunmi Niu, Haitao Zhan

Institution: First Hospital of Qinhuangdao

Language: English

Topic: Pleural and Pulmonary Diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090