TNF-alpha in the Pleural Fluid for the Differential Diagnosis of Tuberculous and Malignant Effusion / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
;
: 625-630, 2005.
Artículo
en Coreano
| WPRIM
| ID: wpr-162061
ABSTRACT
BACKGROUND:
Determining the cause of an exudative pleural effusion is sometimes quite difficult, especially between malignant and tuberculous effusions. Twenty percent of effusions remain undiagnosed even after a complete diagnostic evaluation, including pleural biopsy. The activity of tumor necrosis factor-alpha (TNF-alpha), which is the one of proinflammatory cytokines, is increased in both infectious and malignant effusions. The aim of this study was to investigate the diagnostic efficiency of TNF-alpha activity in distinguishing tuberculous from malignant effusions.METHODS:
46 patients (13 with malignant pleural effusion, 33 with tuberculous pleural effusion) with exudative pleurisy were included. TNF-alpha concentrations were measured in the pleural fluid and serum samples using an enzyme- linked immunosorbent assay (ELISA). In addition, TNF-alpha ratio (pleural fluid TNF-alpha serum TNF-alpha) was calculated.RESULTS:
TNF-alpha concentration and TNF-alpha ratio in the pleural fluid were significantly higher in the tuberculous effusions than in the malignant effusions (p0.05). The cut off points for the pleural fluid TNF-alpha level and TNF-alpha ratio were found to be 136.4 pg/mL and 6.4, respectively. The sensitivity, specificity and area under the curve were 81%, 80% and 0.82 for the pleural fluid TNF-alpha level (p<0.005) and 76%, 70% and 0.72 for the TNF-alpha ratio (p<0.05).CONCLUSION:
We conclude that pleural fluid TNF-alpha level and TNF-alpha ratio can distinguish a malignant pleural effusion from a tuberculous effusion, and can be additional markers in a differential diagnosis of tuberculous and malignant pleural effusion. The level of TNF-alpha in the pleural fluid could be a more efficient marker than the TNF-alpha ratio.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Derrame Pleural
/
Pleuresia
/
Tuberculosis
/
Biopsia
/
Citocinas
/
Derrame Pleural Maligno
/
Factor de Necrosis Tumoral alfa
/
Diagnóstico Diferencial
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Coreano
Revista:
Tuberculosis and Respiratory Diseases
Año:
2005
Tipo del documento:
Artículo
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