Soluble leukocyte selectin in the analysis of pleural effusions.
OBJECTIVE
To determine if soluble leukocyte selectin (sL-selectin) levels in serum and pleural fluid (PF) are an inflammatory marker that differentiates pleural effusion transudates from exudates.


METHODS
sL-selectin PF and serum levels were measured in consecutive patients and compared to established criteria.


METHODS
A tertiary-care military medical center.


METHODS
One hundred twenty patients undergoing diagnostic or therapeutic thoracentesis.


METHODS
PF and serum samples were collected during thoracentesis and analyzed separately for sL-selectin levels. Results were compared with clinical diagnosis and established PF criteria including the criteria of Light et al, cholesterol ratio, total bilirubin ratio, and albumin gradient.


RESULTS
sL-selectin levels in PF and serum were determined in 109 patients. By clinical diagnosis, mean +/- SD PF sL-selectin levels were 200.2 +/- 124.3 ng/mL in transudates and 496.8 +/- 379.2 ng/mL in exudates (p < 0.001). By the criteria of Light et al, mean PF sL-selectin levels were 195.7 +/- 105.2 ng/mL in transudates and 448.2 +/- 367.6 ng/mL in exudates (p < 0.001). Mean sL-selectin PF to serum ratios were 0.31 +/- 0.17 in transudates and 0.72 +/- 0.31 in exudates (p < 0.001) by clinical criteria, and 0.31 +/- 0.18 in transudates and 0.64 +/- 0.33 in exudates (p < 0.001) by the criteria of Light et al. No significant difference was noted with serum sL-selectin levels between groups.


CONCLUSIONS
sL-selectin is an inflammatory marker that differentiates transudates from exudates in pleural effusions and is a sensitive indicator for PF analysis.
Horvath
L L
LL
Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA. Lynn.Horvath@cen.amedd.army.mil
Gallup
R A
RA
Worley
B D
BD
Merrill
G A
GA
Morris
M J
MJ
D015415:Biomarkers / Q000032:analysis*; D005122:Exudates and Transudates / Q000737:chemistry; D006801:Humans; D019041:L-Selectin / Q000032:analysis* / Q000097:blood; D010996:Pleural Effusion / Q000737:chemistry*; D010998:Pleurisy / Q000175:diagnosis; D012680:Sensitivity and Specificity
D015415:Biomarkers; D019041:L-Selectin