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OSTEOPONTIN AND C REACTIVE PROTEIN IN PLEURAL FLUID

Department of Chemical Pathology, Medical Research Institute Alexandria Universi, Alexandria, Egypt

PURPOSE: Background The first step in the evaluation of patients with pleural effusion is todetermine whether the effusion is a transudate or an exudate. Osteopontin (OPN) isa pleiotropic integrin-binding protein with many functions. We assessed pleuraleffusion and serum concentrations of OPN and C reactive protein (CRP) in patientswith different types of pleural effusions.

METHODS: Methods The current study comprised three groups: 20 patients with transudativeeffusion, 30 patients with malignant effusion and 30 patients with tuberculouseffusion. OPN was analysed using commercially available enzyme-linkedimmunosorbent assay kit.

RESULTS: Results OPN effusion values were significantly higher in exudates (bothmalignant and tuberculous effusion cases) compared with transudative effusion.Also when compared separately, patients with tuberculous effusion and those withmalignant effusion had a significantly higher fluid and OPN effusion/serum ratiothan those with transudative effusion. Patient with tuberculous effusion had asignificantly higher serum CRP effusion and effusion/serum ratio of CRP than thosewith malignant or transudative effusion.

CONCLUSION: Conclusion OPN is significantly increased in exudative effusion compared withtransudative ones. However, serum OPN and effusion/serum OPN ratio were notsignificantly different in patients with malignant and those with tuberculouseffusions. The lack of difference in serum OPN and effusion/serum OPN ratiobetween patients with malignant and those with tuberculous effusion may beattributed to the heterogeneity of the malignant effusion group. Receiver-operatingcurves analysis has shown that effusion/serum CRP ratio outperformed effusion/serum OPN ratio as a diagnostic marker for tuberculous pleural effusion.

CLINICAL IMPLICATIONS: Elevated OPN level may suggest that the effusion is a seconadry to Tuberculous pleursy. However, CRP offer a better diagnostic performance than OPN.

DISCLOSURE: Mahmoud Ragab, No Financial Disclosure Information; No Product/Research Disclosure Information