Source: Annual Congress 2010 - Novel approach in diagnosis and treatment of pleural effusions
Disease area: Respiratory infections, Thoracic oncology

Abstract

Background: It is very important to discriminate quickly between malignant and non-malignant pleural effusion. Furthermore, even with the aid of routine invasive procedures, 10-20% of patients remain without diagnosis. The clinical significance of various biomarkers, measured in both serum and/or pleural fluids, is far to be demonstrated.
Aims: The aim of the study was to compare the serum and pleural fluid concentration of different biological markers in order to establish the inflammatory or malignant origin of pleural effusions
Methods: Seventy-five consecutive patients with pleural effusion were studied prospectively, 63 pts with pleural exudates (33 of inflammatory origin and 30 of malignant origin) and 12 pts with transudative effusions. In particular, c-reactive protein (CRP), procalcitonin (PCT) carcinoembryonic antigen (CEA) and neuronspecific enolase (NSE) were tested.
Results: Pleural fluid CRP levels were significantly higher in patients with inflammatory effusions compared to malignant (p< 0,05) or transudative effusion (p< 0,01). On the contrary, PCT was not found able to discriminate these patients. Pleural fluid CEA and NSE levels were significantly higher in patients with malignant effusions compared to inflammatory ones (p< 0,01).Using a cut- off point of 7,525 ng/ml, NSE presented 69,6% sensitivity and 84,6% specificity for the diagnosis of malignant vs inflammatory effusions.
Conclusions: we conclude that the measurement of the CRP, CEA and NSE levels at the onset of pleural effusion may provide useful information for the differential diagnosis in clinical practice

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Citations should be made in the following way:
L. Pisani, A. Ricci, G. Gencarelli, L. Martone, P. Bruno, L. Tabbì, F. Fioretti, V. Pietrangeli, A. Proietti, S. Mariotta (Rome, Italy). Diagnostic role of biology markers in 75 patients with pleural effusion. Eur Respir J 2010; 36: Suppl. 54, 225

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