Association of Pleural pH, Glucose, and ΔIL-8 with Pleurodesis Outcome in Malignant Pleural Effusion

Sari

Malignant pleural effusion (MPE) is a common complication of advanced lung adenocarcinoma associated with dyspnea, impaired quality of life, and significant morbidity. Pleurodesis is widely used for palliation, but predictors of treatment success remain limited. This study aimed to evaluate the predictive value of pleural pH, glucose, and interleukin-8 (IL-8) in determining pleurodesis outcomes in MPE patients. A retrospective cross-sectional study was conducted at RSUD Jenderal Ahmad Yani Metro from July 2023 to July 2024 involving 32 cytology-confirmed adenocarcinoma patients undergoing bleomycin pleurodesis before chemotherapy using consecutive sampling. Pleurodesis success was defined as complete or partial response without repeat pleural intervention within one month. IL-8 levels were measured before and 24 hours after pleurodesis. Statistical analysis used Kruskal–Wallis and post-hoc Mann–Whitney tests with 95% confidence interval. The complete response group demonstrated significantly higher pleural pH (7.5 ± 0.2) and glucose levels (96.9 ± 44.6 mg/dL) compared with failure cases (pH 6.9 ± 0.3; glucose 39.4 ± 24.5 mg/dL) (p < 0.001 and 0.001, respectively). Delta IL-8 levels were significantly higher in successful pleurodesis compared with failure groups (p < 0.001), while absolute IL-8 levels showed no significant difference. Higher pleural pH, glucose, and increased post-procedural IL-8 response were associated with successful pleurodesis. These findings highlight the potential role of combining pleural biochemical parameters with dynamic inflammatory biomarkers to optimize patient selection and improve quality-of-life outcomes in MPE management.