Mediators in pleural effusions of different origin: a two-step diagnostic study.
| Autor: | Fricke, Stephan, Hoheisel, Gerhard, Gessner, Christian, Bauer, Katrin, Seyfarth, Hans-Jürgen, Hammerschmidt, Stefan, Kahlenberg, Franka, Chan, Kin, Boldt, Andreas, Wirtz, Hubert, Keller, Thomas, Sack, Ulrich |
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| Předmět: |
HEART failure
LUNG tumors PLEURAL effusions TUBERCULOSIS diagnosis BIOMARKERS CONFIDENCE intervals DIFFERENTIAL diagnosis ENZYME-linked immunosorbent assay INTERLEUKINS LONGITUDINAL method PROTEOLYTIC enzymes RESEARCH funding LOGISTIC regression analysis VASCULAR endothelial growth factors RECEIVER operating characteristic curves DIAGNOSIS |
| Zdroj: | Journal of Laboratory Medicine / Laboratoriums Medizin; Jul2014, Vol. 38 Issue 3, p121-127, 7p |
| Abstrakt: | Background: Many mediators in pleural effusions give diagnostic information. This study therefore aimed to find out whether the repeated determination of interleukin (IL)-6, IL-15, vascular endothelial growth factor (VEGF), and tissue inhibitors of metalloproteinase (TIMP)-2 would confirm previous results and, furthermore, whether a combination of these parameters could achieve a higher diagnostic yield. Methods: Two consecutive groups of patients with pleural effusions were included. The underlying disease entities in series I vs. series II were: 12 vs. 0 tuberculosis (TB), 19 vs. 30 primary lung cancer, 7 vs. 14 secondaries to the lung, 5 vs. 13 congestive heart failure, and 2 vs. 7 parapneumonic effusion. Results: VEGF could not differentiate values of series I to the same degree as in series II. For IL-15, totally deviating levels were obtained in series II. IL-6, however, showed comparable results in both series. Values of TIMP-2 were generally higher in series II. The diagnostic accuracies of VEGF and IL-6 were comparable. With logistic regression, the data of VEGF and IL-6 could be used as a classifying tool when TB cases were excluded. The classifying tool based on the data of series I showed a high degree of diagnostic accuracy (area under the curve, AUC=0.94) in contrast to the calculation based on the data of series II (AUC=0.56). Combining both series, VEGF was superior. Conclusions: VEGF was confirmed as a valid marker for malignant diseases. VEGF in combination with IL-6 could serve as a classifying tool. TB cases, however, should be excluded. The previously proposed relevance of TIMP-2 as a diagnostic parameter could, similarly to IL-15, not be confirmed. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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