Determination of tissue polypeptide-specific antigen in pleural fluid and serum from patients with pleural effusion

1995 ◽  
Vol 10 (3) ◽  
pp. 161-165 ◽  
Author(s):  
V. Villena ◽  
J. Echave-Sustaeta ◽  
A. Lopez-Encuentra ◽  
P. Martin-Escribano ◽  
J. Estenoz-Alfaro ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Specific Antigen ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Cytologic Analysis

As a tool for differentiating malignant and benign pleural effusions, we evaluated the diagnostic value of the assay of tissue polypeptide-specific antigen (TPS) in pleural fluid and serum, and of the pleural fluid TPS/serum TPS ratio in patients with pleural effusion. We studied prospectively 147 consecutive patients who had pleural effusions: 43 malignant pleural effusions and 104 benign pleural effusions. TPS levels were measured by RIA. The sensitivity and specificity of these measurements were: TPS in pleural fluid (cutoff 20,000 U/L): 0.21 and 0.98; TPS in serum (cutoff 300 U/L): 0.31 and 0.96; pleural fluid TPSI serum TPS ratio (cutoff 1200): 0.07 and 0.99. All these values enhanced the sensitivity of cytologic analysis of pleural fluid. However, we conclude that TPS assay in pleural fluid and serum, and the pleural fluid TPSI serum TPS ratio have limited diagnostic value in patients with pleural effusion.

scholarly journals Assessment of the diagnostic value of CEA, CA125, and CRP and their cut-off point for discrimination of exudative pleural effusions

Bionatura ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 1944-1947
Author(s):  
Hanie Raji ◽  
Seyed Hamid Borsi ◽  
Mehrdad Dargahi MalAmir ◽  
Ahmad Reza Asadollah Salmanpour
Keyword(s):  
Pleural Effusion ◽  
Tumor Marker ◽  
Pleural Fluid ◽  
Tumor Markers ◽  
Low Cost ◽  
High Specificity ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
The Mean

Pleural effusion is divided into exudative and transudative effusion, and the distinction between exudate and transudate requires multiple investigations of biochemical parameters and their comparison in pleural fluid and serum. This study aimed to assess the diagnostic value of CEA, CA125, and CRP and their cut-off point for discrimination of exudative pleural effusions. This epidemiological and cross-sectional study was performed on 50 patients aged between 18 to 90 years with the diagnosis of exudative pleural effusion referred to Imam Khomeini Hospital in Ahvaz in 2018 and 2019. Demographic and clinical information of patients were collected. The pleural effusion was diagnosed based on physical examination and chest radiography. Pleural effusion was confirmed by thoracentesis. A pleural fluid sample was taken from all patients, and the levels of CEA, CA125, and CRP markers were measured in the pleural fluid. Differentiation of transudate and exudate pleural effusions was performed using Light criteria. The mean CEA and CA125 level of pleural fluid were significantly higher, and the mean CRP level of pleural fluid was significantly lower in patients with malignant diagnoses (P <0.05). Cut-off value with highest sensitivity and specificity in differentiating types of exudative pleural effusions was obtained for CEA tumor marker (greater than 49.8), CA125 tumor marker (greater than 814.02), and CRP marker (less than 7.56). Also, in differentiating types of exudative pleural effusions, CEA tumor marker had sensitivity (89.03%) and specificity (78.42%); CA125 tumor marker had sensitivity (53.18%) and specificity (62.44%), and CRP marker had sensitivity (82.16%), and specificity (89.05%) were. Although the tumor markers had high specificity in the present study, the low sensitivity of some of these tumor markers reduced their diagnostic value. On the other hand, given the numerous advantages of tumor markers, such as low cost and non-invasive, combining them with another can increase the diagnostic value and accuracy.

scholarly journals Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neda Dalil Roofchayee ◽  
Majid Marjani ◽  
Neda K. Dezfuli ◽  
Payam Tabarsi ◽  
Afshin Moniri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
New Biomarkers ◽  
High Level

AbstractPatients with tuberculous pleural effusion (TPE) or malignant pleural effusions (MPE) frequently have similar pleural fluid profiles. New biomarkers for the differential diagnosis of TPE are required. We determined whether cytokine profiles in the PE of patients could aid the differential diagnosis of TPE. 30 patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP) and 14 patients with parapneumonic effusion (PPE) were enrolled between Dec 2018 and 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL8, CCL-1 and IP-10 were determined in PE by ELISA along with measurements of adenosine deaminase (ADA). The best predictors of TPE were combined ADA.IL-27 [optimal cut-off value = 42.68 (103 U ng/l2), sensitivity 100%, specificity 98.28%], ADA [cut off value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] and IL-27 [cut-off value = 2363 (pg/ml), sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001]. A high level of IL-6 [cut-off value = 3260 (pg/ml), sensitivity 100%, specificity 67.2%], CXCL8 [cut-off value = 144.5 (pg/ml), sensitivity 93.3%, specificity 58.6%], CCL1 [cut-off value = 54 (pg/ml), sensitivity 100%, specificity 70.7%] and IP-10 [cut-off value = 891.9 (pg/ml), sensitivity 83.3%, specificity 48.3%] were also predictive of TPE. High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy and may be useful clinically.

scholarly journals Pleural Fluid Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Complicated and Uncomplicated Parapneumonic Pleural Effusions

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Adel Salah Bediwy ◽  
Mohamed Gamal A. Elkholy ◽  
Mohamed Mohamed Elbedewy ◽  
Mohamed A. Hasanein
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Myeloid Cells ◽  
Area Under The Curve ◽  
Pleural Effusions ◽  
Cutoff Value ◽  
High Concentrations ◽  
Early Diagnose

Background. Soluble triggering receptor expressed on myeoid cells-1 (sTREM-1) has recently been found to be high in infected pleural fluid (PF). Objectives. Diagnostic accuracy of PF sTREM-1 for differentiating uncomplicated parapneumonic effusions (UPPEs) from complicated parapneumonic effusions (CPPEs) was evaluated prospectively. Methods. Serum and PF sTREM-1 were measured for 68 patients with parapneumonic and transudative pleural effusion. Results. PF (but not serum) sTREM-1 concentrations were significantly higher in CPPE than in UPPE. Serum and PF sTREM-1 levels were higher in parapneumonic than in transudative groups. PF sTREM-1 had a sensitivity of 85.19% and a specificity of 83.33% at cutoff value of 250.5 pg/mL for differentiating CPPE and UPPE with area under the curve (AUC) of 0.9336. After excluding purulent CPPE cases, sensitivity and specificity became 90.48% and 83.33%, respectively (at the same cutoff value) with AUC of 0.9444. Conclusion. High concentrations of PF sTREM-1 (above 250.5 pg/mL) help to early diagnose and differentiate CPPE from UPPE.

Pleural Fluid Pseudouridine in Malignant and Benign Pleural Effusions

1998 ◽  
Vol 35 (1) ◽  
pp. 94-98 ◽  
Author(s):  
T W L Mak ◽  
S S Ho ◽  
C S Ho ◽  
M G Jones ◽  
C K W Lai ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Roc Curve ◽  
Curve Analysis ◽  
Pleural Effusions ◽  
Clinical Value ◽  
Roc Curve Analysis ◽  
Malignant Pleural Effusions ◽  
Bonferroni Adjustment ◽  
Malignant Group

Pseudouridine in urine and plasma has been proved to be a useful tumour marker in many malignant conditions. We studied its usefulness in pleural fluid for distinguishing malignant from non-malignant pleural effusions. Pleural fluid pseudouridine concentrations in different groups of patients with pleural effusion (31 malignant, 29 benign, 16 unknown, 1 double pathology) was measured and compared. Its usefulness in distinguishing malignant from non-malignant pleural effusions was analysed by receiver-operating characteristic (ROC) curve analysis. Pseudouridine concentrations in the malignant group were significantly higher than the non-malignant group ( P < 0.017, Bonferroni adjustment) with values overlapping extensively at the lower end. The area-under-the curve (AUC) value in the ROC curve analysis was 0.675 ( P < 0.05). We conclude that the pleural fluid pseudouridine is of limited clinical value in distinguishing malignant from non-malignant pleural effusion due to its extensive overlap. However, it is useful when the concentration is higher than 65 μmol/L, which indicates malignancy.

Telomerase activity in pleural effusions: diagnostic significance.

1998 ◽  
Vol 16 (2) ◽  
pp. 567-573 ◽  
Author(s):  
C T Yang ◽  
M H Lee ◽  
R S Lan ◽  
J K Chen
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Telomerase Activity ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Diagnostic Significance ◽  
Group Iii ◽  
Malignant Pleural Effusions ◽  
Group I ◽  
Group Ii

PURPOSE To determine the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a nonmalignant pleurol effusion in a cohort of patients undergoing thoracentesis. PATIENTS AND METHODS Using a polymerase chain reaction (PCR)-based assay, telomerase activity was examined in the pleural fluid cells obtained from 144 consecutive, unselected patients. According to the final diagnosis achieved, these patients were classified into three groups: group I consisted of 70 malignant pleural effusions diagnosed by either fluid cytology or pleural biopsy, group II consisted of 52 nonmalignant pleural effusions, and another 22 samples were categorized to be suspicious malignant pleural effusions (group III) due to inconclusive results in effusion cytology and percutaneous pleural biopsy, but were strongly suspicious in clinical settings. RESULTS The presence of telomerase activity was observed in 64 of 70 samples in group I (91.4%), three of 52 samples in group II (5.8%), and 20 of 22 samples in group III. All three nonmalignant, telomerase-positive pleural effusion samples in group II were obtained from patients with tuberculosis. As a diagnostic criterion for malignant pleural effusion in group I and group II patients, positive telomerase activity had a sensitivity of 91.4%, a specificity of 94.2%, and a positive and negative predictive value of 0.96 and 0.89, respectively. CONCLUSION Our results indicate that the detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions.

scholarly journals Rapid automated determination of adenosine deaminase and lysozyme for differentiating tuberculous and nontuberculous pleural effusions

1996 ◽  
Vol 42 (2) ◽  
pp. 218-221 ◽  
Author(s):  
V Villena ◽  
J A Navarro-Gonzálvez ◽  
C García-Benayas ◽  
J A Manzanos ◽  
J Echave ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Cutoff Values ◽  
Serum Lysozyme ◽  
Automated Procedures ◽  
Automated Determination

Abstract The catalytic concentration of pleural adenosine deaminase (ADA) and the ratio of pleural lysozyme (PL) to serum lysozyme (SL) were measured in consecutive patients (49 tuberculous and 179 nontuberculous) with two automated procedures in a Hitachi 717 analyzer. Using sensitivity and specificity curves, we established cutoff values at 33 U/L for ADA and 1.7 for the PL/SL ratio. The sensitivity of ADA activities for tuberculous effusion was 90%, specificity 85%. Combining ADA with the PL/SL ratio enhanced specificity to 99%. However, high values for ADA and lysozyme ratios are not, alone or in combination, sensitive or specific enough to replace pleural biopsy or culture of pleural fluid for the diagnosis of tuberculous empyema.

scholarly journals Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

2020 ◽  
Author(s):  
Neda Dalil Roofchayee ◽  
Majid Marjani ◽  
Neda K.Dezfuli ◽  
Payam Tabarsi ◽  
Afshin Moniri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Extrapulmonary Tuberculosis ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
New Biomarkers ◽  
High Level

Abstract Background: Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. Patients with tuberculous or malignant pleural effusions (MPE) frequently have similar clinical manifestations and pleural fluid profile. New biomarkers for the differential diagnosis of TPE are required. Objective: We sought to determine of whether cytokine profiles in the pleural effusion of patients were suitable as tools for the differential diagnosis of TPE. Methods: 30 patients with TPE, 30 patients with MPE, 14 patients with empyema and 14 patients with parapneumonic effusion were enrolled consecutively from the Masih Daneshvari Hospital, Tehran, Iran between Dec 2018-Dec 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL-8, CCL-1 and IP-10 were determined in pleural effusions by ELISA along with measurements of adenosine deaminase (ADA). Results: The levels of all analytes measured except IL-18 were higher in TPE compared with non-TPE subjects (all p < 0.01). The best predictors of TPE were combined ADA.IL-27 (optimal cut-off value = 42.68 103.U.ng/L2, sensitivity 100%, specificity 98.28%, p ≤ 0.0001), ADA (optimal cut off value 27.5 IU/L, sensitivity 90%, specificity 96.5%, p ≤ 0.0001) and IL-27 (optimal cut-off value = 2363 pg/ml, sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001). A high level of IL-6 (optimal cut-off value = 3260 pg/ml, sensitivity 100%, specificity 67.2%, p ≤ 0.0001), CXCL-8 (optimal cut-off value = 144.5 pg/m, sensitivity 93.3%, specificity 58.6%, p ≤ 0.0001), CCL-1 (optimal cut-off value = 54 pg/mL, sensitivity 100%, specificity 70.7%, p ≤ 0.0001) and IP-10 (optimal cut-off value = 891.9 pg/mL, sensitivity 83.3%, specificity 48.3%, p = 0.0001) were also predictive of TPE. Conclusion: High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy.

scholarly journals Pleural fluid cholesterol level is an important parameter in differentiating exudative from transudative pleural effusions

2018 ◽  
Vol 5 (3) ◽  
pp. 520
Author(s):  
Chakradhar Majhi ◽  
Butungeshwar Pradhan ◽  
Bikash C. Nanda ◽  
Sagnika Tripathy
Keyword(s):  
Pleural Effusion ◽  
Cholesterol Level ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Pleural Effusions ◽  
Biochemical Tests ◽  
Etiological Diagnosis ◽  
Multiple Parameters ◽  
Fluid Analysis ◽  
Cholesterol Levels

Background: The first important step is to decide whether the pleural effusion is transudate or exudates by Light’s criteria. Light’s criteria can misclassify 25% of pleural transudates as exudates. Pleural fluid cholesterol level can differentiate transudates from exudates as a single parameter instead of multiple parameters used in Light’s criteria. Measurement of pleural fluid cholesterol levels to differentiate transudative effusions from exudative effusions.Methods: Consecutive 60 cases of pleural effusion were taken in the study. Pleural fluid analysis was done for parameters of Light’s criteria along with pleural fluid cholesterol levels. First exudative and transudative effusion was classified by Light’s criteria. Other  clinical and relevant  biochemical tests were done to arrive in  the final etiological diagnosis  and data were collected and analysed .Pleural fluid cholesterol levels was  correlated to Light’s criteria.Results: Total 60 cases of pleural effusion were there in the study. There were 43 exudative and 17 transudative effusions. Mean cholesterol level was 64.2± 7.5mg/dl in exudative effusions and 26.05±8.01 mg/dl in transudates. Pleural fluid cholesterol was ≥55mg /dl in 43 cases of exudates and <55mg/dl in 17 cases of transudates.Conclusions: Pleural fluid cholesterol level of ≥ 55mg/dl had similar sensitivity and specificity to Light’s criteria and as a single important parameter to differentiate exudative from transudative pleural effusion

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