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Background Pleural effusion may be malignant or nonmalignant, Cytology has been used in malignant pleural effusion (MPE) diagnosis due to its high specificity. Its sensitivity is about 0.6. Cancer ratio (CR) and carcinoembryonic antigen (CEA) may be used in MPE diagnosis. Aim Evaluate the role of CR and CEA as diagnostic markers of MPE and their role in differentiating different types of MPE. Patients and methods This cross-sectional study included 70 patients with pleural effusion admitted to Chest Department, Kasr Alainy Faculty of Medicine, Cairo University. Thirtyfive patients had benign pleural effusions and 35 patients had MPE. Pleural fluid sample obtained from each patient for ADA, CEA, and serum LDH. CR and pleural fluid CEA were compared between patients with MPE and those with benign effusion. Results CR was statistically significantly higher in the malignant group (mean 23.66±7.75) compared with benign group (mean 14.47±11.42) with P value less than 0.001. CR cut-off value was 19.79, the sensitivity and specificity were 74.3 and 82.9%, respectively. Pleural fluid CEA had higher levels in malignant group (mean 104.78±262.7) compared with benign group (mean 2.08±2.49) with P value less than 0.001. The cut-off value of CEA was 3.4 U/l with sensitivity 74.3% and specificity 94.3%. Pleural fluid CEA was significantly higher in metastatic adenocarcinoma (mean 154.58±314.53) compared with other types of malignancy (mean 9.34±17.98) with P value less than 0.001. Conclusion CR and CEA could be used together as simple screening tests in cytology negative MPE with high specificity and sensitivity. CEA was significantly higher in metastatic adenocarcinoma compared with other types of malignancy and could be used to differentiate different types of MPE. [ABSTRACT FROM AUTHOR]

Introduction: Breast Cancer (BC) is the most common type of cancer among women worldwide and a leading cause of cancer related deaths. Based on insight into immune system/cancer interactions, cancer immunotherapy strategies have been developed. Of these strategies, immune checkpoints regulators are among the most important. Programmed Death Ligand 1 (PD-L1) is one of the 2 ligands of Programmed Death-1 (PD-1); an important immune checkpoint regulator. Clinical trials using PD-L1 antibodies have shown efficacy in various cancers. Some of these antibodies have received Food and Drug Administration (FDA) approval for clinical use. Aim: Detection of Immunohistochemical (IHC) expression of PD-L1 by Tumour Cells (TC) and stromal Tumour Infiltrating Lymphocytes (TILs) in female BC, as well as, correlation of this expression with the pathologic parameters of the tumours. Materials and Methods: One hundred BC tissue sections were collected from mastectomy specimens. IHC expression of PD-L1 was investigated in TC and TILs. Correlation of PD-L1 expression with the tumours pathologic parameters was performed using Statistical Package of Social Science (SPSS) Software program, version 25.0. Results: TC PD-L1 expression was detected in 61% of cases and showed statistically significant correlation with higher tumour grade, higher prognostic stage, Estrogen receptor negativity, Human Epidermal Growth Factor Receptor Type 2 (HER2) enriched molecular subtype and LVI (p-value <0.05). TILs PD-L1 expression was detected in 55% of cases and showed statistically significant correlation with higher tumour grade, higher prognostic stage, Estrogen and Progesterone receptor negativity, HER2 overexpression, higher Ki-67 index, triple negative molecular subtype and higher stromal TILs (p-value <0.05). Conclusion: The present results supported PD-L1 expression in BC by both TC and TILs, with higher expression in subset of tumours that are high grade, TILs rich and lacking hormone receptors, highlighting them as candidates for anti-PD-1/PD-L1 therapy. [ABSTRACT FROM AUTHOR]