Özlem DOĞAN, Fatma ÇİFTCİ, Serhat EROL, Gülden BİLGİN, Ayşe Naz ÖZCAN, Aycan YÜKSEL, Aydın ÇİLEDAĞ, Akın KAYA

The diagnostic role of pentraxin-3 in the differential diagnosis of pleural effusions

Background/aim: Discrimination of pleural effusion etiology is not always easy in clinical practice. Pentraxin-3 (PTX-3) is a new acutephase protein. The aim of this study was to investigate the role of PTX-3 in the differential diagnosis of pleural effusions.Materials and methods: This prospective study enrolled all consecutive patients from two tertiary hospitals who underwent diagnosticor therapeutic thoracentesis. In a cohort of 149 subjects with pleural effusion, including transudates and malignant (MPE), tuberculous(TPE), and parapneumonic effusion (PPE), serum and pleural effusion PTX-3 concentration measurements were performed usingELISA. Serum and pleural effusion protein, lactate dehydrogenase, C-reactive protein (CRP), and adenosine deaminase levels were alsoassessed.Results: Of these patients, 34 had transudates, 29 had PPE, 63 had MPE, and 23 had TPE. There was a weak correlation between pleuraleffusion PTX-3 level and serum CRP (P < 0.01). There was a significant difference in pleural PTX-3 levels between the exudative effusiongroups (P < 0.01). The median pleural effusion PTX-3 was significantly higher in patients with PPE (11.2 ng/mL, 2–17.8) than MPE (4.7ng/mL, 1.8–13.9) and TPE (3.1 ng/mL, 2.0–4.1). At a cut-off point of 5.89 ng/mL, PTX-3 had the best discriminatory power for PPEversus other exudative effusions (sensitivity: 86.2%, specificity: 87.7%). The exudative effusion group had a significantly different pleuraleffusion/serum PTX-3 ratio (P = 0.03).Conclusion: PTX-3 concentration in pleural effusion was elevated without a significant correlation with serum PTX-3 in PPE. Theseresults may suggest that PTX-3 is a local acute-phase reactant and may allow discrimination of PPE from other exudative effusions.

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