ABSTRACT
Objective: To investigate the diagnostic value of flexirigid thoracoscopy in patients with malignant pleural effusion. Methods: From October 2007 to June 2010, 32 patients with malignant pleural effusion were retrospectively reviewed. In these patients, the routine, biochemistry, microbiology and cytology laboratory tests all failed to make the diagnosis. Then these patients received flexirigid thoracoscopy and the diagnosis of cause was identified. Results: In thirty-two patients with malignant pleural effusion, twenty-eight were diagnosed as having lung cancer (twenty-two had adenocarcinoma and six had poorly differentiated carcinoma), two were diagnosed as having lymphoma, and two were diagnosed as having malignant pleuralmesothelioma. No other serious adverse events occurred except for one case with postoperative fever. Conclusion: Flexirigid thoracoscopy is a simple, safe and effective clinical technique in the diagnosis of malignant pleural effusion. When the routine examinations can not identify the pathogenesis of malignant pleural effusion, the thoracoscopy should be applied.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test (SPT) in patients allergic to Dermatophagoides pteronyssinus.</p><p><b>METHODS</b>Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen. Three kinds of house dust mite allergen extracts were used for SPT, including the Dermatophagoides pteronyssinus extract prepared by our laboratory (group A), standardized Dermatophagoides pteronyssinus extract (group B), and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae (group C). Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.</p><p><b>RESULTS</b>SPT results showed that the median wheal diameter of group A, group B, and group C was 0.43, 0.35, and 0.28 cm, respectively, with significant difference among three groups (P<0.05). The difference was significant between group A and B (P<0.01) as well as group A and C (P<0.01), but not between group B and C (P>0.05). There was no local urticaria or systemic allergic reactions following the procedure of SPT. Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A. As for group B and C, local reaction occurred in 3 cases and delayed reaction in 2 cases in each group. The area under ROC curve of SPT with extract in group A, group B, and group C was 0.765, 0.801, and 0.782, respectively. Based on the detection results of serum specific IgE, the sensitivity of SPT in diagnosis of Dermatophagoides pteronyssinus allergy with extract of group A, group B, and group C was 92.4%, 87.0%, and 81.5%, and the specificity was 60.6%, 73.2%, and 74.8%, respectively.</p><p><b>CONCLUSION</b>The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts, and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.</p>