Abstract
PFC is the less invasive method for diagnosing pleural neoplasms and the reported sensitivity is 50%.
Methods: All patients evaluated at our institution who had PFC and CB done between May 2009 to June 2010 and had PB indicated where included in the study. Diagnostic categories were specified for the analysis of PC and CB. The pathologist who read the PFC and CB was blind to the PB final diagnosis. The accuracy of the techniques was compared to PB.
Statistical analysis: Kappa (k) index was used to evaluate the concordance between the different techniques versus the PB and the concordance between PFC and CB. The sensitivity and specificity for malignancy was established for every technique.
Results: 92 patients were included in the study. The PB was positive in 71 (77%) cases. The PFC was positive in 42 (45.6%) and the CB was positive in 35 (38%) of the cases. PB/PFC agreement was 68.5%; k=0.4. PB/CB agreement was 61.5%; k=0.32. PFC/CB agreement was 84.6%; k=0.68. Eleven out of 12 effusions with PFC suspicious of malignancy turned out to be malignant when compared to PB and all the suspicious CB where malignant in the PB. For PFC sensitivity was 64.3%, specificity was 100%, with a positive predicted value (PPV) of 100% and a negative predicted value of (NPV) 45%. For CB sensitivity was 59.2%, specificity was 100% with a PPV of 100% and a NPV of 42%.
Conclusion: There is good agreement between PFC and CB for the diagnosis of malignancy. CB trends to agree more than PFC with PB in the diagnosis of pleural mesothelioma. The sensitivity and specificity of PFC in the diagnosis of malignancy is similar to what is reported in the literature.
- © 2011 ERS