Pleural interleukin-1β in differentiating transudates and exudates:: Comparative analysis with other biochemical parameters

被引:19
作者
Alexandrakis, MG
Kyriakou, D
Alexandraki, R
Pappa, KA
Antonakis, N
Bouros, D
机构
[1] Univ Crete, Sch Med, Dept Hematol, Iraklion, Crete, Greece
[2] Univ Crete, Sch Med, Dept Pneumonol, Iraklion, Crete, Greece
[3] Univ Crete, Sch Med, Dept Social Med, Iraklion, Crete, Greece
[4] Venizel Gen Hosp, Iraklion, Crete, Greece
关键词
cytokines; transudate; exudate; pleural fluid; IL-1; beta;
D O I
10.1159/000063620
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: The differential diagnosis of pleural effusion is a frequent clinical problem. The possible role of pleural fluid cytokines in discriminating transudates from exudates has not been studied adequately. Objective: The aim of this study was to evaluate the serum and pleural fluid levels of interleukin-1beta (IL-1beta) and to compare it with common biochemical parameters such as cholesterol (CHOL), lactate dehydrogenase (LDH), total protein and albumin. Methods: One hundred and six consecutive patients with pleural effusion were studied. IL-1beta was measured simultaneously in blood and pleural fluid using a radioimmunoassay. Standard laboratory methods were employed for biochemical parameters. Results: Using ROC analysis, a pleural IL-1beta cutoff level 18.16 fmol/ml had a sensitivity of 76.8%, a specificity of 58.3% and a positive predictive value (PPV) 86.3% in the discrimination of transudates vs. all exudates. Serum IL-1beta levels were higher in the nonmalignant group but without statistical difference compared with transudate patients. In addition, a significant difference was found between serum IL-1beta in the malignant group in comparison with those of the transudate group (p < 0.01), also IL-1beta levels were significantly increased in exudate effusion when compared with transudate (p < 0.001, p < 0.05, respectively). CHOL values of greater than or equal to65 mg/dl had 92.7% sensitivity, and 100% specificity and PPV for both. Conclusions: The results of this study suggest that although IL-1beta could be a marker with relatively good sensitivity and PPV for the differentiation of pleural effusion, the cost and time needed do not support its use as a routine laboratory test. Copyright (C) 2002 S. Karger AG, Basel.
引用
收藏
页码:201 / 206
页数:6
相关论文
共 19 条
[1]   Diagnostic value of ferritin, haptoglobin, alpha(1)-antitrypsin, lactate dehydrogenase and complement factors C3 and C4 in pleural effusion differentiation [J].
Alexandrakis, M ;
Coulocheri, S ;
Kyriakou, D ;
Bouros, D ;
Xirouhaki, N ;
Siafakas, N ;
Castanas, E ;
Eliopoulos, GD .
RESPIRATORY MEDICINE, 1997, 91 (09) :517-523
[2]   Significance of alpha-2-macroglobulin, alpha-1-acid glycoprotein, and C-reactive protein in pleural effusion differentiation [J].
Alexandrakis, MG ;
Coulocheri, SA ;
Bouros, D ;
Vlachonikolis, IG ;
Eliopoulos, GD .
RESPIRATION, 2000, 67 (01) :30-35
[3]   Tumor markers in the diagnosis of malignant serous effusions [J].
Cascinu, S ;
DelFerro, E ;
Barbanti, I ;
Ligi, M ;
Fedeli, A ;
Catalano, G .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1997, 20 (03) :247-250
[4]   CURRENT CONCEPTS - LYMPHOKINES [J].
DINARELLO, CA ;
MIER, JW .
NEW ENGLAND JOURNAL OF MEDICINE, 1987, 317 (15) :940-945
[5]  
GJAMARKAJ M, 1994, CHEST, V106, P1041
[6]   CHOLESTEROL IN PLEURAL EFFUSIONS - A DIAGNOSTIC-AID [J].
HAMM, H ;
BROHAN, U ;
BOHMER, R ;
MISSMAHL, HP .
CHEST, 1987, 92 (02) :296-302
[7]   Diagnostic value of tests that discriminate between exudative and transudative pleural effusions [J].
Heffner, JE ;
Brown, LK ;
Barbieri, CA ;
Burgess, L ;
Cruz, E ;
Pose, A ;
Roth, BJ ;
Suay, VG ;
Valdes, L .
CHEST, 1997, 111 (04) :970-980
[8]   CHYLIFORM (CHOLESTEROL) PLEURAL EFFUSION [J].
HILLERDAL, G .
CHEST, 1985, 88 (03) :426-428
[9]   Proinflammatory cytokines and fibrinolytic enzymes in tuberculous and malignant pleural effusions [J].
Hua, CC ;
Chang, LC ;
Chen, YC ;
Chang, SC .
CHEST, 1999, 116 (05) :1292-1296
[10]   PLEURAL EFFUSIONS - DIAGNOSTIC SEPARATION OF TRANSUDATES AND EXUDATES [J].
LIGHT, RW ;
LUCHSINGER, PC ;
MACGREGOR, MI ;
BALL, WC .
ANNALS OF INTERNAL MEDICINE, 1972, 77 (04) :507-+