Vol.11, No 2, 2004 pp. 69 - 73
UC 612.123:616.25-003.217
DIAGNOSTIC UTILITY OF CHOLESTEROL
IN DIFFERENTIATION OF PLEURAL EXUDATES FROM
TRANSUDATES
Ivanka N. Djordjević1, Milan M.
Radović1, Slavica N. Golubović1,
Dragana V. Dačić1, Tatjana A. Pejčić1,
Jasna V. Lalić2
1University of Niš, School of Medicine,
Clinic for Lung Diseases and TBC-Knez Selo, Clinical Centre, Niš, Serbia
2Medical Centre for Biochemistry, Clinical
Centre, Niš, Serbia
Summary. Evaluation of the utility of measurement of pleural fluid
cholesterol (CHOLpf and CHOLpf/s) in differentiation of exudates
(Ex) from transudates (Tr), was the aim of our study.
We analysed 200 patients with pleural effusions (PE) of known etiology,
and the results were compared with the criteria of Light et al. According
to their etiology 44 (22.2%) of PE were Tr and 156 (78.8%) were Ex. Receiver
operating characteristics (ROC) curve, were used to determine the
best cut-off values for CHOLpf and CHOLpf/s.
All analysed cut-off values of CHOLpf and of CHOLpf/s showed a significantly
higher specificity (from 61.4% to 97.8%) in comparison to Light's criteria
(56.8%) - (p<0.01). Using of 60 mg/dl cut-off value of CHOLpf and 0.40
of CHOLpf/s, we reached the highest specificity (79.5% and 97.8% respectively).
The sensitivity and efficiency of all cut-off values of cholesterol were
almost the same as in Light's criteria (p>0.01).
Light's criteria remain the best biochemical criteria for the classification
of transudates and exudates. The high level of sensitivity, efficiency
and significantly higher specificity in comparison to Light's criteria,
makes CHOLpf with cut-off value of 60 mg/dl and CHOLpf/s with cut-off value
of 0.40 to be used as alternative parameter in differentiation of transudates
from exudates.
Key words: Cholesterol, pleural effusions, transudates, exudates
DIJAGNOSTIČKI ZNAČAJ HOLESTEROLA
PRI DIFERENTOVANJU PLEURALNIH EKSUDATA
OD TRANSUDATA
Kratak sadržaj: Cilj ove studije bila je evaluacija značaja merenja
koncentracije holesterola u pleuralnoj tečnosti (HOLp i HOLp/s)u cilju
diferentovanja eksudata (E) od transudata (T).
Analizirano je 200 pacijenata sa pleuralnim izlivom (PI) poznate etiologije
a dobijeni rezultati komparirani su sa Light-ovim kriterijumima. Na osnovu
etiološkog uzročnika diferentovano je 44 (22,2%) T i 156 (78,8%) E. Receiver-operating-characteristic
(ROC) kriva korišćena je za odredjivanje najtačnijih graničnih vrednosti
HOLp i HOLp/s. Sve granične vrednosti HOLp i HOLp/s pokazale
su signifikantno veću specifičnost (od 61,4% do 97,8%) u poredjenju sa
Light-ovim kriterijumima (56,8%)-(p<0,01). Granične vrednosti HOLp od
60 mg/dl i HOLp/s od 0,40 pokazale su najveću specifičnost (79,5% odnosno
97,8%). Senzitivnost i efikasnost svih graničnih vrednosti holesterola,
gotovo su iste sa Light-ovim kriterijumima (p>0,01).
Light-ovi kriterijumi ostaju i dalje najbolji biohemijski kriterijumi
za klasifikovanje transudata od eksudata. Visoka senzitivnost i efikasnost,
kao i signifikantno veća specifičnost HOLp sa graničnom vrednosti od 60
mg/dl i HOLp/s sa graničnom vrednosti od 0,40 u odnosu na Ligh-ove kriterijume,
omogućuje primenu holesterola kao alternativnog parametra pri diferentovanju
eksudata od transudata.
Ključne reči: Holesterol, pleuralni izliv, transudati, eksudati
