The role of biochemical markers in the differential diagnosis of plevral efusions

This study, it was aimed to investigate the role of various biochemical markers in the differential diagnosis of malignant and benign pleural effusion (PE). Our study included 115 volunteer patients older than 20 years of age, who were hospitalized in the thoracic surgery clinic, and had pleural effusion in chest radiography or thorax CT. Age and gender distributions of patients with malignant and benign pleural effusions are similar. The histopathological diagnosis of all patients with malignant pleural effusion was confirmed. Simultaneous glucose, albumin, protein and lactate dehydrogenase (LDH), homocysteine, vitamin B12, and folate levels are tested in PEs and serums. Hemogram parameters such as White Blood Cell (WBC), Red Blood Cell (RBC), Hemoglobin (HGB), Hematocrit (HCT), Platelet (PLT), Lymphocyte (LYM), Monocyte (MONO), Neutrophil (NEUT) and serum C-Reactive Protein (CRP) levels were checked. In addition, Extracellular matrix protein 1 (ECM1), Pentraxin 3 (PTX-3) and Neuron-specific enolase (NSE) levels were measured in PE. As a result of the analysis of the data obtained from the study, it was seen that the lymphocyte value in patients with benign PE was significantly higher than in patients with malignant PE. In the current study, the values of serum albümin, serum protein, serum vitamin B12 PE and vitamin B12, serum folate PE and serum folate, PTX3 PE in patients with benign PE; serum LDH, homocysteine PE, serum homocysteine, ECM1 PE and NSE PE values were found to be significantly higher in patients with malignant PE. In addition, as a result of the ROC analysis, the sensitivity and specificity of homocysteine PE were 0.761 and 0.541, respectively, while 0.739 and 0.574 for homocysteine serum; 0.609 and 0.590 for ECM1 PE; NSE is 0.913 and 0.918 for PE and 0.689 and 0.711 for PTX 3. These results show the that NSE PE value is a more effective biochemical marker in differentiating malignant-benign PE compared to others.