Abstract
BackgroundWe previously demonstrated that the pleural levels of proteins (neutrophil gelatinase-associated lipocalin/NGAL, calprotectin, bactericidal permeability-increasing/BPI, azurocidin 1/AZU-1) were valuable markers for identifying complicated PPE (CPPE). Herein, this study was performed to evaluate whether these proteins are useful as serological markers for identifying CPPE and empyema.MethodsA total of 137 participates were enrolled in this study. The levels of NGAL, calprotectin, BPI and AZU-1 were measured in serum and pleural fluid by enzyme-linked immunosorbent assay. We also characterized the diagnostic values of these markers between different groups.ResultsThe serum levels of NGAL, calprotectin, and BPI in PPE patients were significantly higher than those in transudates, noninfectious exudates, and healthy controls. The area under the curve (AUC) values of NGAL, calprotectin, and BPI for distinguishing PPE from transudates or noninfectious exudates were around 0.861 to 0.953. In PPE group, serum NGAL and calprotectin levels were significantly elevated in patients with CPPE and empyema than in those with UPPE, whereas the serum BPI levels were similar between these two groups. In CPPE and empyema patients, the serum NGAL showed a positive correlation with the pleural fluid NGAL (r = 0.417, p < 0.01). When combined with serum CRP, the sensitivity and specificity of serum calprotectin for identifying CPPE and empyema were the highest at 73.52% and 80.55%, respectively.ConclusionsWe concluded that serum calprotectin and NGAL were adjuvant serological markers for CPPE and empyema diagnosis. Patients present with pneumonia and pleural effusion signs in the chest x-ray and the combination of serum calprotectin and CRP constitutes a more highly sensitive and specific assay for identifying CPPE and empyema.
Highlights
We previously demonstrated that the pleural levels of proteins were valuable markers for identifying complicated Parapneumonic effusion (PPE) (CPPE)
We previously found that four neutrophil-associated proteins in pleural effusions were significantly elevated in PPE and served as useful markers for identifying complicated PPE (CPPE) and empyema [16]
PE culture was performed on uncomplicated PPE (UPPE), CPPE, and empyema cases, and was positive in 0 (0%) of 40 UPPE, 0 (0%) of 17 CPPE, 16 (76.2%) of 21 empyemas
Summary
We previously demonstrated that the pleural levels of proteins (neutrophil gelatinase-associated lipocalin/NGAL, calprotectin, bactericidal permeability-increasing/BPI, azurocidin 1/AZU-1) were valuable markers for identifying complicated PPE (CPPE). This study was performed to evaluate whether these proteins are useful as serological markers for identifying CPPE and empyema. The acutephase protein (C-reactive protein [CRP]) and many inflammatory cytokines (IL-6, IL-8, IL-1α, IL-1β and TNFα) have been studied in both the sera and pleural effusions of pneumonia patients [9,10,11,12,13]. We previously found that four neutrophil-associated proteins (neutrophil gelatinaseassociated lipocalin [NGAL], calprotectin, bactericidal permeability-increasing [BPI] and AZU1) in pleural effusions were significantly elevated in PPE and served as useful markers for identifying CPPE and empyema [16]. We investigate whether the serum levels of these four proteins had diagnostic value and to determine the best combination of serum biomarkers for a rapid and accurate diagnosis of CPPE and empyema
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
