Online ISSN: 2515-8260

Co-Relation OfCytomorphology With Absolute Ldh Gradient And Fluid Ada Levels In Determining The Type Of Pleural Effusion.

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Dr. Dennis VinnetShinde(PG Resident)1 , Dr. Anjali Singh (Prof.) 2 , Dr. SanjeevNarang (Prof. and HOD) 3 ,Dr. V.K. Jain (Prof.) 4 , Dr. Romi Srivastava (Assoc. Prof.) 5 ,Dr. ParulMaheshwari (Asst. Prof.)6 , Dr. Rahul Karode(Asst. Prof.)7

Abstract

Present Study is done with an aim to co-relate the cytomorphology with Absolute LDH gradient and Fluid ADAlevels in determining the type of pleural effusion. On calculating the mean Absolute LDH gradient (serum-fluid LDH after dropping the negative sign)along with standard deviation after performing the biochemical analysis of pleural fluid, the exudative effusion fluid had an absolute LDH gradient value of 3356.20+4985.20 U/L (highest), tubercular effusion fluid had an absolute LDH gradient value of 1361.36+ 1609.50 U/L, malignant/ suspicious of malignancy effusion fluid had an absolute LDH gradient value of 1376+1181.79 U/L while transudative fluid had an absoluteLDH gradient value of 107.91+61.60U/L (lowest). On calculating the mean ADA levels along with standard deviation after performing the biochemical analysis, the exudative effusion fluid (including tubercular) had an ADA value of 54.37+56.71U/L (highest), malignant/ suspicious of malignancy effusion fluid had an ADA value of 31.09+02.81U/L while transudative effusion fluid had an ADA value of 23.46+15.22U/L (lowest). The mean and standard deviation values of ADA according to cytology reports showed that it was highest in chronic inflammatory smear (exudates- tubercular) and least in case of inflammatory smears (transudate). The mean and standard deviation values of Absolute LDH gradient according to cytology reports showed that it was highest in acute inflammatory smears (exudates) and found to be least in case of inflammatory smears (transudate). Using the Biserial correlation method, when the cytologic types of pleural fluid were correlated with absolute LDH gradient values the p- value (0.011) was found to be statistically significant in acute inflammatory smears (exudates). Alternatively, when the cytologic types of pleural fluid were correlated with pleural fluid ADA values the p- value (0.001) was found to be statistically significant in chronic inflammatory smears (tubercular-exudates). Cytomorphological analysis of body fluids is an important investigation which is very convenient, cost effective, accurate and also safe . It gives a clue to diagnose any underlying neoplastic or non- neoplastic diseases that may change prognosis, further management or outcome of patient. In cases of malignant effusion it is crucial in staging and deciding further protocol of treatment.

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