Procalcitonin as a diagnostic marker in differentiating parapneumonic effusion from tuberculous pleurisy or malignant effusion
- Authors
- Lee, Seung Hyeun; Lee, Eun Joo; Min, Kyung Hoon; Hur, Gyu Young; Lee, Sung Yong; Kim, Je Hyeong; Shin, Chol; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho; Lee, Sang Yeub
- Issue Date
- 10월-2013
- Publisher
- PERGAMON-ELSEVIER SCIENCE LTD
- Keywords
- Biologic markers; Pleural effusion; Procalcitonin; Parapneumonic effusion
- Citation
- CLINICAL BIOCHEMISTRY, v.46, no.15, pp.1484 - 1488
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL BIOCHEMISTRY
- Volume
- 46
- Number
- 15
- Start Page
- 1484
- End Page
- 1488
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/102007
- DOI
- 10.1016/j.clinbiochem.2013.03.018
- ISSN
- 0009-9120
- Abstract
- Objectives: Differential diagnosis of exudative pleural effusions can be difficult, despite the use of several biomarkers. Serum procalcitonin (s-PCT) is a well-known biomarker for systemic bacterial infections. However, the usefulness of pleural fluid procalcitonin (pf-PCT) in clinical practice has not been established. This study evaluated the usefulness of PCT measurements in differentiating parapneumonic effusion (PPE) from tuberculous (TB) pleurisy or malignant effusion. Design and methods: Ninety eight adult patients diagnosed with exudative pleural effusion were enrolled and allocated into the PPE group (n = 32), TB pleurisy group (n = 40), or malignant effusion group (n = 26). Both s-PCT and pt-PCT concentrations were measured at admission using an immunoluminometric assay. Results: Both s-PCT and pf-PCT were significantly increased in the PPE group compared with the TB pleurisy or malignant effusion groups (p < 0.001). The optimal cut-off value for s-PCT in the diagnosis of PPE was 0.18 ng/mL (sensitivity 83.3%, specificity 81.0%). The pf-PCT cut-off value was 0.16 ng/mL (sensitivity 81.5%, specificity 72.1%). Serum PCT exhibited better diagnostic accuracy than pf-PCT, with areas under the receiver operating characteristic curves of 0.842 for s-PCT and 0.784 for pf-PCT (p = 0.015). In addition, s-PCT and pf-PCT showed better diagnostic accuracy than serum C-reactive protein (p = 0.005 and p = 0,023, respectively). Conclusions: Measurement of s-PCT and pf-PCT is useful in differentiating PPE from TB pleurisy and malignant effusion. Both s-PCT and pf-PCT may be useful biomarkers in the differential diagnosis of exudative pleural effusions. (c) 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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