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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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Acute phase markers for the differentiation of infectious and malignant pleural effusions

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Author
Kiropoulos, T. S.; Kostikas, K.; Oikonomidi, S.; Tsilioni, I.; Nikoulis, D.; Germenis, A.; Gourgoulianis, K. I.
Date
2007
DOI
10.1016/j.rmed.2006.09.019
Keyword
Acute phase response markers
C-reactive protein
Interleukin-6
Pleural effusion
Tumor necrosis factor alpha
C reactive protein
interleukin 6
adult
aged
article
clinical practice
congestive heart failure
controlled study
cytokine production
diagnostic value
differential diagnosis
female
human
major clinical study
male
pleura cancer
pleura effusion
pleura fluid
priority journal
respiratory tract inflammation
sensitivity and specificity
serum
tuberculous pleurisy
validation process
Acute-Phase Proteins
Aged, 80 and over
Biological Markers
Diagnosis, Differential
Epidemiologic Methods
Exudates and Transudates
Humans
Middle Aged
Pleural Effusion, Malignant
Pneumonia, Bacterial
Tuberculosis, Pleural
Tumor Necrosis Factor-alpha
Metadata display
Abstract
Acute-phase markers, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α), have been studied in inflammatory and malignant disorders. We examined the diagnostic value of these markers for the differentiation among parapneumonic, tuberculous and malignant effusions. We studied 124 patients with pleural effusions, classified as exudates [total (n=97), parapneumonic (n=15), tuberculous (n=25), malignant (n=57)] and transudates due to congestive heart failure (n=27). CRP, IL-6 and TNF-α were measured in pleural fluid and serum. Pleural fluid CRP was higher in parapneumonic compared to tuberculous and malignant effusions, providing 100% sensitivity for a cut-off point of 5.3 mg/dL. IL-6 was higher in both parapneumonic and tuberculous compared to malignant effusions. TNF-α was higher in tuberculous compared to malignant effusions, providing 96.0% sensitivity, and 93.0% specificity for a cut-off point of 88.1 pg/mL. Pleural fluid CRP levels were lower than serum in all groups, probably reflecting systemic inflammation, whereas IL-6 and TNF-α were higher in pleural fluid indicating local production. Our data suggest that these markers may provide useful information for the differentiation of infectious and malignant effusions in clinical practice. However, further studies are needed for the validation of these findings in usual clinical circumstances. © 2006.
URI
http://hdl.handle.net/11615/29436
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