Tuberc Respir Dis.  2007 Apr;62(4):290-298. 10.4046/trd.2007.62.4.290.

Soluble Triggering Receptor Expressed on Myeloid cells-1: Role in the Diagnosis of Pleural Effusions

• Kim JH
• Park EY
• Kim WH
• Park W
• Jeong HC
• Lee JH
• Kim EK

• KMID: 1970229
• DOI: http://doi.org/10.4046/trd.2007.62.4.290

Abstract

BACKGROUND: The currently available diagnostic markers for pleural effusion have a limited role. The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a molecule recently reported to play an important role in the myeloid cell mediated inflammatory response, and is up regulated in the body fluid by bacterial or fungal products. This study examined the expression of sTREM-1 in pleural effusion.
METHODS
Between April 2004 and December 2005, 48 patients with pleural effusions were enrolled in this study. The pleural fluids were taken and analyzed for the total protein, glucose, lactate dehydrogenase (LDH), adenosine deaminase (ADA), and sTREM-1. Bacterial cultures and cytology tests were also performed.
RESULTS
The clinical diagnoses were 17 parapneumonic, 14 tuberculous, and 13 malignant effusions. Four patients presented with transudates. The mean ages of the parapneumonic, tuberculous and malignant effusion groups were 57.1+/-19.7, 49.5+/-18.6, 66.9+/-15.5, and 76.0+/-18.1. respectively. The level of sTREM-1 expression was significantly higher in the parapneumonic effusions (344.0+/-488.7) than in the tuberculous effusions (81.7+/-56.6) and malignant effusions (39.3+/-19.6). With a cut-off value of 55.4pg/ml, the sensitivity and specificity for a parapneumonic effusion was 70.6% and 74.1%.
CONCLUSION
sTREM-1 expression is significantly higher in parapneumonic effusions, suggesting its potential role as an additional diagnostic marker for pleural effusions.

Keyword

Triggering receptor expressed on myeloid cells; Pleural effusion; Differential diagnosis

MeSH Terms

Adenosine Deaminase
Body Fluids
Diagnosis*
Diagnosis, Differential
Exudates and Transudates
Glucose
Humans
L-Lactate Dehydrogenase
Myeloid Cells
Pleural Effusion*
Adenosine Deaminase
Glucose
L-Lactate Dehydrogenase

Figure

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  Figure 1 Flow chart of the diagnosis of the pleural effusions.

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  Figure 2 Levels of pleural sTREM-1 among the groups. *p=0.018, †p=0.008

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  Figure 3 ROC curve of pleural sTREM-1 for parapneumonic effusion.

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  Figure 4 Correlation of pleural fluid sTREM-1 and pleural fluid PMN count (A), pleural LDH (B) and ADA (C) by Spearman's correlation method.

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