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Pentraxin‐3: A novel biomarker for discriminating parapneumonic from other exudative effusions
Author(s) -
Ozsu Savas,
Abul Yasin,
Mentese Ahmet,
Bektas Hayriye,
Uzun Aysegul,
Ozlu Tevfik,
Porcel José M.
Publication year - 2013
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12038
Subject(s) - medicine , confidence interval , odds ratio , biomarker , gastroenterology , prospective cohort study , pleural effusion , parapneumonic effusion , area under the curve , logistic regression , receiver operating characteristic , diagnostic odds ratio , pleural fluid , biochemistry , chemistry
Background and objective Pentraxin‐3 ( PTX ‐3) is a relatively new marker of inflammation that has not been previously tested in pleural effusions. We aimed to assess whether PTX ‐3 is an accurate biomarker of parapneumonic effusions ( PPE ) and whether it discriminates complicated ( CPPE )from non‐complicated PPE . Methods The concentrations of pleural fluid PTX ‐3 were measured by a commercial enzyme‐linked immunosorbent assay in a prospective cohort of 84 patients with pleural effusions, including 24 PPE , 40 malignant, and 20 miscellaneous exudative effusions. The area under the curve quantified the overall diagnostic accuracy of the test. A multivariate logistic regression analysis selected pleural fluid biochemistries predictive of PPE . Results Median pleural fluid PTX ‐3 levels were higher in PPE than in both malignant effusions and other exudates (32.4 ng/ mL vs 6.7 ng/ mL , and 8.5 ng/ mL , respectively, P < 0.001). PTX ‐3 > 12 ng/ mL yielded 88% sensitivity, 73% specificity, likelihood ratio positive 3.3 and likelihood ratio negative 0.17 for diagnosing PPE , with an area under the curve of 0.855 (95% CI : 0.769–0.941). In the multivariate analysis, pleural PTX ‐3 levels remained associated with increased diagnostic odds for PPE (odds ratio 17.7, 95% confidence interval: 3.7–85.1, P < 0.001). There was a non‐significant trend towards higher pleural PTX ‐3 levels in CPPE as compared with non‐complicated. Conclusions High concentrations of PTX‐3 in pleural effusions are very sensitive to differentiate PPE from non‐PPE. However, they do not seem to differentiate uncomplicated‐complicated from CPPE differentiation.