ArticleMalawi medical journal : the journal of Medical Association of Malawi2025
Optimizing Diagnostic Strategies for Malignant Serous Cavity Effusion: The Role of Cytomorphological Examination Combined with High Fluorescent Cells and Total Protein.
Article in Malawi medical journal : the journal of Medical Association of Malawi, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study evaluated the diagnostic value of cytomorphological examination in malignant serous cavity effusion (MSCE) and optimized clinical strategies by integrating routine cytological and biochemical analysis. Methods: A retrospective analysis was conducted on 3,998 patients with serous cavity effusion at the First Affiliated Hospital of Xi'an Jiaotong University. Based on cytopathological results, patients were classified into MSCE (1,078 cases) and benign serous cavity effusion (BSCE, 2,920 cases) groups. Diagnostic performance of cytomorphological examination was assessed, and routine cytological and biochemical parameters were compared. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic efficacy. Results: Cytomorphological examination showed a sensitivity of 82.9%, specificity of 86.3%, and accuracy of 85.0%, with high concordance with cytopathological diagnosis (κ = 0.687, P < 0.001). High fluorescence cell count (HFC) and total protein (TP) were significantly elevated in the MSCE group and positively correlated with MSCE (P < 0.001). HFC (AUC: 0.765, 95% CI: 0.748-0.782; cutoff: 24.5×10 Conclusion: Cytomorphological examination showed high sensitivity and high specificity in the diagnosis of MSCE. Its combination with HFC and TP effectively enhances diagnostic performance by achieving a balance between reducing missed diagnoses and minimizing misdiagnoses.
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