Discrimination of exudative pleural effusions based on multiple biological parameters

¹ Dept of Respiratory Medicine and
² Dept of Biomathematics, University of Thessaly School of Medicine, Larissa, Greece.

^* To whom correspondence should be addressed. E-mail: zintza{at}med.uth.gr.

	Abstract

Pleural effusion is a common complication of different diseases. Conventional methods are not always capable to establish the cause of pleural effusion and alternative tests are needed.

to explore the discrimination of pleural effusion groups: malignant, parapneumonic and tuberculous, based on a function of seven biological markers.

Adenosine deaminase (ADA), interferon- (INF-), C-reactive protein (CRP), carcinoembryonic antigen (CEA), interleukin (IL)-6, tumour necrosis factor (TNF)- and vascular endothelial growth factor (VEGF) were measured in pleural fluid in: 45 patients with malignant (MPE), 15 with parapneumonic (PPE) and 12 with tuberculous (TBE) pleural effusion. ROC curve analysis, multinomial logit modeling and canonical variate analysis were applied to discriminate the pleural effusion groups.

The three groups can be discriminated successfully using the measured markers. The most important parameters for discrimination were ADA and CRP. An individual with ADA more than 45 and CRP less than 4 is more likely to belong to TBE, whereas, one with ADA less than 40 and CRP more than 6 to PPE, and one with CRP less than 4 to MPE.

Combination of ADA and CRP might be sufficient to discriminate the three different groups of exudative pleural effusion, malignant, tuberculous and parapneumonic.