title: Diagnostic value of suPAR in differentiating noncardiac pleural effusions from cardiac pleural effusions.
abstract: BACKGROUND
  Soluble urokinase plasminogen activator receptor (suPAR) is a newly discovered inflammatory biomarker. suPAR has not been previously studied in differentiating noncardiac pleural effusion (PF) from cardiac PF. The aim of our study was to assess the diagnostic value of suPAR in PF.
  
  
  METHODS
  The concentration of PF-suPAR was measured by a commercialized enzyme-linked immunosorbent assay in a prospective cohort of 74 patients with PF, 18 patients with PF due to cardiac failure (CF) and 56 patients with noncardiac PF. The area under the curve quantified the overall diagnostic accuracy of the tests.
  
  
  RESULTS
  The median pleural fluid suPAR level was found as 23 (5.4-102.8) ng/mL. The median PF-suPAR level in CF was significantly lower than that of noncardiac effusions [11.8 (5.4-28.9) ng/mL vs 26.7 (8.2-102.8) ng/mL, respectively, P < 0.001]. The area under the receiver operating characteristic curve was 0.878 (95% confidence interval: 0795-0.962, P < 0.001) for noncardiac pleural fluid suPAR. The sensitivity, specificity and positive predictive value of PF-suPAR for noncardiac effusions at the cutoff level of ≥17.6 n/mL was 88%, 83% and 94%, respectively. The suPAR level in PF was found to correlate with all of the biochemical parameters of PF.
  
  
  CONCLUSIONS
  suPAR is a potential new marker for the discrimination between cardiac and noncardiac PF.
authors.affiliation: Pulmonary Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Ozsu
authors.affiliation: Pulmonary Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Oztuna
authors.affiliation: Department of Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Mentese
authors.affiliation: Pulmonary Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Abul
authors.affiliation: Pulmonary Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ozlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055293:Receptors, Urokinase Plasminogen Activator / Q000378:metabolism
chemical_list: D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator
keywords: diagnosis; pleural effusion; soluble urokinase plasminogen activator receptor