Tuberc Respir Dis.  2013 Dec;75(6):244-249.

Pleural Fluid Pentraxin-3 for the Differential Diagnosis of Pleural Effusions

Affiliations
  • 1Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
  • 2Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. cmcksj@catholic.ac.kr
  • 3Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 5Department of Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 6Department of Biostatistics, Clinical Research Coordinating Center, The Catholic University of Korea, Seoul, Korea.
  • 7Division of Cancer Prevention and Control, Moffitt Cancer Center, Tampa, FL, USA.

Abstract

BACKGROUND
Conventional biomarkers cannot always establish the cause of pleural effusions; thus, alternative tests permitting rapid and accurate diagnosis are required. The primary aim of this study is to assess the ability of pentraxin-3 (PTX3) in order to diagnose the cause of pleural effusion and compare its efficacy to that of other previously identified biomarkers.
METHODS
We studied 118 patients with pleural effusion, classified as transudates and exudates including malignant, tuberculous, and parapneumonic effusions (MPE, TPE, and PPE). The levels of PTX3, C-reactive protein (CRP), procalcitonin (PCT) and lactate in the pleural fluid were assessed.
RESULTS
The levels of pleural fluid PTX3 were significantly higher in patients with PPE than in those with MPE or TPE. PTX3 yielded the most favorable discriminating ability to predict PPE from MPE or TPE by providing the following: area under the curve, 0.74 (95% confidence interval, 0.63-0.84), sensitivity, 62.07%; and specificity, 81.08% with a cut-off point of 25.00 ng/mL.
CONCLUSION
Our data suggests that PTX3 may allow improved differentiation of PPE from MPE or TPE compared to the previously identified biomarkers CRP and PCT.

Keyword

PTX3 Protein; Pleural Effusion

MeSH Terms

Biomarkers
C-Reactive Protein
Diagnosis
Diagnosis, Differential*
Exudates and Transudates
Humans
Lactic Acid
Pleural Effusion*
C-Reactive Protein
Lactic Acid

Figure

  • Figure 1 Levels of pleural fluid concentrations of PTX3 according to different etiologies of pleural effusions. MPE: malignant pleural effusion; TPE: tuberculous pleural effusion; PPE: parapneumonic pleural effusion; PTX3: pentraxin-3. *p<0.05.


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