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Pleural Disease


Wednesday, November 2, 2005

12:30 PM - 2:00 PM

PROTEIC PROFILE OF PLEURAL EFFUSIONS SECONDARY TO TUBERCULOSIS AND MALIGNANCY

Leila Antonangelo, MD, Francisco S. Vargas, MD, Eduardo H. Genofre, MD, Lisete R. Teixeira, MD, Milena M. Acencio, BS, Márcia Seiscento, MD, Evaldo Marchi, MD and Roberta K. Sales, MD*

Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical Sc, São Paulo, Brazil

PURPOSE: To evaluate the proteic profile of tuberculous and neoplastic pleural effusions.

METHODS: Pleural fluid and pleural-serum ratio (PSR) of total protein and eletrophoretic (EF) albumin, alpha, beta and gamma globulin were analysed from 403 patients having tuberculosis (200) or malignant pleural effusions(203). Univariate analysis was applied to compare the results between the groups. Significant difference was considered for a p<0.05.

RESULTS: The results are expressed in median with p value.
Tuberculosis Malignancy
Protein (mg/dl) 5.4 (4.9 –5.7) 4.3 (3.7 –4.9) *
PSR-Protein 0.69 (0.65 –0.73) 0.61 (0.54 –0.65) *
Albumin-EF 2.63 (2.35 –2.9) 2.5 (2.1 –2.8) *
PSR-Albumin 0.77 (0.71 –0.83) 0.77 (0.64 –0.77) *
{alpha}1 globulin-EF 0.23 (0.2 –0.3) 0.2 (0.14 - 0.23) *
PSR-{alpha}1 globulin 0.62 (0.54 –0.7) 0.53 (0.41 –0.62) *
{alpha}2 globulin-EF 0.47 (0.4 –0.6) 0.3 (0.2 –0.4) *
PSR-{alpha}2 globulin 0.52 (0.46 –0.6) 0.36 (0.28 –0.43) *
ß globulin-EF 0.8 (0.62 –0.9) 0.6 (0.46 –0.71) *
PSR-ß globulin 0.69 (0.6 –0.77) 0.52 (0.41 –0.63) *
{delta} globulin-EF 1.14 (0.9 –1.4) 0.7 (0.52 –0.9) *
PSR {delta} globulin 0.64 (0.57 –0.7) 0.55 (0.46 –0.65) *

* p<0.05

CONCLUSION: Total proteins and their subsets were significantly higher in the pleural effusion due to tuberculosis as compared to the malignant, suggesting a more intense inflammatory response in the tuberculous group.

CLINICAL IMPLICATIONS: These data may colaborate in the differentiation between the tuberculous and malignant pleural effusions.

DISCLOSURE: Roberta Sales, None.






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