title: Novel biomarker analysis of pleural effusion enhances differentiation of tuberculous from malignant pleural effusion.
abstract: Lymphocytic pleurisy is commonly observed in tuberculosis and cancer. Noninvasive biomarkers are needed to distinguish tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE) because current clinical diagnostic procedures are often invasive. We identified immune response biomarkers that can discriminate between TPE and MPE. Fourteen pleural effusion biomarkers were compared in 22 MPE patients and five TPE patients. Of the innate immunity biomarkers, the median levels of interleukin (IL)-1β and interferon-induced protein-10 (IP-10) were higher in TPE patients than in MPE patients (P<0.05 and P<0.01, respectively). Of the adaptive immunity biomarkers, the median levels of IL-13 and interferon-γ (IFN-γ) were higher in TPE patients than in MPE patients (P<0.05). In addition, the levels of basic fibroblast growth factor were higher in MPE patients than in TPE patients (P<0.05). Receiver operator characteristic analysis of these biomarkers was performed, resulting in the highest area under the curve (AUC) for IP-10 (AUC =0.95, 95% confidence interval, P<0.01), followed by IL-13 (AUC =0.86, 95% confidence interval, P<0.05). Our study shows that five biomarkers (IL-1β, IP-10, IFN-γ, IL-13, and basic fibroblast growth factor) have a potential diagnostic role in differentiating TPE from MPE, particularly in lung cancer-related MPE.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Kuan-Yuan
authors.initials: KY
authors.lastname: Chen
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Po-Hao
authors.initials: PH
authors.lastname: Feng
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Tzu-Tao
authors.initials: TT
authors.lastname: Chen
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Hsiao-Chi
authors.initials: HC
authors.lastname: Chuang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Chun-Nin
authors.initials: CN
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Chien-Ling
authors.initials: CL
authors.lastname: Su
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Kang-Yun
authors.initials: KY
authors.lastname: Lee
keywords: biomarkers; lung cancer; malignant pleural effusion; tuberculous pleural effusion