Pleural effusion is an abnormal accumulation of fluid in the pleural space resulting from increased production of fluid or decreased resorption of fluid in the pleural space. Pleural effusion can be caused by infectious diseases, malignancies, collagen disease, gastrointestinal disease, heart disease and other causes such as medication. Adenosine Deaminase (ADA) is an enzyme involved in the catabolism of purines. This enzyme can be measured in pleural fluid, serum and other body fluids such as cerebrospinal and ascites fluid. The aim of this study was to analyze the correlation between adenosine deaminase activity in pleural fluid and serum in patients with pleural effusion. This research was an observational study with a cross-sectional design. Examination of ADA activity was performed in pleural fluid and serum. Adenosine deaminase activity was examined using photometric methods (Non-Giusti), using Diazyme reagent by TMS 24i Premium. Subjects were 46 patients with pleural effusion caused by malignancies, tuberculosis and systemic diseases. Mean±SD ADA activity for all pleural effusion samples in serum was 13.037± 8.365 (0.5-34.1) U//L and pleural fluid 30.843± 28.860 U//L (1.3-140.8). No correlation between ADA activity in serum and pleural fluid (r=0.173, p= 0.252) was found in all samples. No correlation between ADA activity in serum and pleural fluis was found in malignancies (r=0.109, p=0.630), tuberculosis (r= 0.366, p=0.123), systemic diseases (r =0.466, p=0.429) and non-tuberculosis group (r=0.126, p=0.532). There was no correlation between pleural fluid ADA activity and serum.
Background: Adenocarcinoma is the highest histology subtype of lung cancer. Epidermal Growth Factor Receptor (EGFR) is a factor that can predict the prognosis or response to treatment in patients with lung adenocarcinoma. Adenocarcinomas with EGFR mutations generally have a component of Ground Glass Opacity (GGO), smaller size, oval shape, multiple nodal metastases, and distant metastases.  The aim of this study was to determine the relationship between EGFR mutations and CT scan images in pulmonary adenocarcinoma patients.Methods: This was a retrospective analytical study consisting of 92 samples, which were categorized into the mutation group (n = 62) and wild group (n = 30). This study was conducted at Dr. Soetomo General Hospital from January 2015 – December 2017. The assessed CT-Scan findings were tumor size, shape, density, lymph node size, pleural effusion, and metastasis presence. The relationship was analyzed using the chi-square test and considered significant if the p-value was < 0.05.Results: This study found a significant relationship between EGFR mutations status with tumor size ≤ 3 cm (p = 0.02), lymph node size < 1.5 cm (p = < 0.001) and metastasis (p = 0.026). However, tumor density, tumor form, and pleural effusion did not have significant relationship with EGFR mutation.Conclusion: Tumor size ≤ 3 cm, lymph node size < 1.5 cm and presence of metastasis can be found in EGFR mutations pulmonary adenocarcinoma patients.
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