INVESTIGATING CHOLESTEROL LEVELS IN PLEURAL FLUID IMPLICATIONS FOR DIAGNOSIS OF MALIGNANT PLEURAL EFFUSIONS

Classifying an effusion as exudative or transudative is only the first step in unraveling the complex network of diagnostic challenges that lie beneath the surface of each hydrothorax. The focus is shifted towards applying an approach tailored to each specific case. Personalized assessment is crucial for making an informed decision about which biochemical markers should be tested. A controversial notion in the field of pleural effusions is the potential for pleural fluid to be analyzed for the presence of cholesterol. Its levels, either alone or in relation to those in the blood, further narrow the diagnostic scope and pave the way for an accurate identification of malignant pleural effusions. In an attempt to clarify the role of cholesterol in the diagnosis of malignant pleural effusions we carried out a one-year-long case-control observational study, which included patients of varying age, clinical manifestation and primary ethiology. A total of 151 patients were included in the analysis. The control group consisted of 72 patients, all of whom were diagnosed with benign disease, confirmed by subsequent biopsy. Of these, 38 cases were confirmed as inflammatory, and 34 were verified as pleural effusions of non-inflammatory origin. Malignant pleural involvement was confirmed in 79 patients. These two groups are representative of the main types of pleural pathology.