Scholarlink

Background <p>Exudative pleural effusion (EPE) remains a diagnostic and therapeutic challenge. Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), have been proposed as non-invasive, cost-effective tools for diagnosis and prognosis. This study aimed to evaluate the diagnostic accuracy and prognostic significance of pleural fluid NLR and MLR in EPE.</p> Methods <p>This prospective cohort study included 60 patients with EPE at Alexandria Main University Hospital. Pleural fluid was analyzed for cell differentials, including neutrophils, monocytes, and lymphocytes. NLR and MLR were calculated. Diagnostic accuracy in differentiating malignant from non-malignant effusions and prognostic outcomes, including ICU admission, 30-day mortality, and recurrence, were evaluated.</p> Results <p>NLR and MLR were significantly lower in malignant pleural effusions (NLR: 1.21 ± 0.68; MLR: 0.19 ± 0.09) compared to benign effusions (NLR: 2.65 ± 1.24; MLR: 0.34 ± 0.13), with <i>p</i> &lt; 0.001. A high NLR was significantly associated with ICU admission (30% vs. 10%, <i>p</i> = 0.03), higher 30-day mortality (20% vs. 3.3%, <i>p</i> = 0.04), and recurrence (36.7% vs. 13.3%, <i>p</i> = 0.02).</p> Conclusion <p>Pleural fluid neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios are practical, inexpensive, and non-invasive markers for differentiating between malignant and benign exudative pleural effusions. Moreover, high NLR values correlate with adverse clinical outcomes, making it a potential tool for prognostication. Incorporating these markers into routine pleural fluid analysis could enhance diagnostic accuracy and inform management strategies, especially in settings with limited resources.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Diagnostic and prognostic utility of pleural fluid neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios in exudative pleural effusion

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月22日

查看全文
  • Mohamed Sabry Eltarhony

摘要

Background

Exudative pleural effusion (EPE) remains a diagnostic and therapeutic challenge. Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), have been proposed as non-invasive, cost-effective tools for diagnosis and prognosis. This study aimed to evaluate the diagnostic accuracy and prognostic significance of pleural fluid NLR and MLR in EPE.

Methods

This prospective cohort study included 60 patients with EPE at Alexandria Main University Hospital. Pleural fluid was analyzed for cell differentials, including neutrophils, monocytes, and lymphocytes. NLR and MLR were calculated. Diagnostic accuracy in differentiating malignant from non-malignant effusions and prognostic outcomes, including ICU admission, 30-day mortality, and recurrence, were evaluated.

Results

NLR and MLR were significantly lower in malignant pleural effusions (NLR: 1.21 ± 0.68; MLR: 0.19 ± 0.09) compared to benign effusions (NLR: 2.65 ± 1.24; MLR: 0.34 ± 0.13), with p < 0.001. A high NLR was significantly associated with ICU admission (30% vs. 10%, p = 0.03), higher 30-day mortality (20% vs. 3.3%, p = 0.04), and recurrence (36.7% vs. 13.3%, p = 0.02).

Conclusion

Pleural fluid neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios are practical, inexpensive, and non-invasive markers for differentiating between malignant and benign exudative pleural effusions. Moreover, high NLR values correlate with adverse clinical outcomes, making it a potential tool for prognostication. Incorporating these markers into routine pleural fluid analysis could enhance diagnostic accuracy and inform management strategies, especially in settings with limited resources.