Clinical application of confocal laser endomicroscopy in the diagnosis of malignant pleural effusion

Our study demonstrates that pCLE is a valuable tool for enhancing the diagnosis of MPE, with high concordance with histopathological findings (kappa = 0.79, p < 0.001) and significant guidance for thoracoscopic pleural biopsies. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pCLE were 96.77%, 80%, 92.68%, 93.75%, and 88.89%, respectively, when compared with histopathology. These results indicate that pCLE can effectively differentiate between benign and malignant pleural effusion in patients with undetermined etiology and serves as a robust complementary method to existing diagnostic approaches. However, the small sample size of this study limits the generalizability of the findings, and further large-scale, multicenter clinical trials are needed to validate these results.