Diagnostic value of four coagulation function indicators for distinguishing between tuberculous pleural effusions and malignant pleural effusions due to lung adenocarcinoma

Abstract Background: Coagulation function indicators are often used to evaluate patients’ coagulation function.They are rarely used in disease diagnosis;their use is limited to somecoagulopathies. We described the pattern of coagulation function indicators in patients with pleural effusions and determined the diagnostic value of different abnormal patterns of these indicators for distinguishing tuberculous pleural effusions (TPEs) from malignant pleural effusions associated with lung adenocarcinoma (AD-MPEs).Methods: Patients with AD-MPEs or TPEs participated in this retrospective study.Coagulation functionindicators, including activated partial thromboplastin time, prothrombin time (PT), fibrinogen (FIB), thrombin time, fibrinogen degradation products (FDP), and D-dimer(D-D), were measured; their levels and abnormal patterns were analyzed separately and in combination,to determine the diagnostic performance of individual and combined values and the optimal diagnostic model.Results: One hundred patients with AD-MPEs and 84 patients with TPEs participated.PT, FIB, FDP, and D-Dlevels in patients with TPE were significantly higher than those in patients with AD-MPE (all P<0.01).Receiver operating characteristiccurves revealed that PT, FIB, FDP, and D-Dvalues, particularly FDP and D-D, could distinguish betweenAD-MPE and TPE. The diagnostic performance was better for the combination of the four indicators than for any single indicator (Youden’s index: 0.513; area under the curve: 0.810).The proportion of patients with abnormal patterns of all four indicators was significantly higher in those with TPE than in those with AD-MPE (P<0.001).Conclusions: Thecombined values of PT, FIB, FDP, and D-Dhave diagnostic value for distinguishing TPE from AD-MPE.