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Kim, Park, Kim, Park, Jeong, Lee, and Kim: Soluble Triggering Receptor Expressed on Myeloid cells-1: Role in the Diagnosis of Pleural Effusions
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(4): 290-298.

Published online: 30 April 2007

DOI: https://doi.org/10.4046/trd.2007.62.4.290

Soluble Triggering Receptor Expressed on Myeloid cells-1: Role in the Diagnosis of Pleural Effusions

Jung-Hyun Kim, M.D.1, Eun-Young Park2, Won-Hee Kim, M.D.1, Woong Park, M.D.1, Hye-Cheol Jeong, M.D.1, Ji-Hyun Lee, M.D.1, Eun-Kyung Kim, M.D.1

1Department of Internal Medicine, College of Medicine, Pochon CHA University, Sungnam, Korea.

2Asan Life Science Institute, Asan Medical Center, Seoul, Korea.

Address for correspondence: Eun-Kyung Kim, M.D. Division of Pulmonology & Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam City, Kyunggi-do, 463-712, Korea. Phone: 82-31-780-5220, Fax: 82-31-780-5219, imekkim@cha.ac.kr

Received 9 May 2007       Accepted 17 April 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

The currently available diagnostic markers for pleural effusion have a limited role. The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a molecule recently reported to play an important role in the myeloid cell mediated inflammatory response, and is up regulated in the body fluid by bacterial or fungal products. This study examined the expression of sTREM-1 in pleural effusion.

Methods

Between April 2004 and December 2005, 48 patients with pleural effusions were enrolled in this study. The pleural fluids were taken and analyzed for the total protein, glucose, lactate dehydrogenase (LDH), adenosine deaminase (ADA), and sTREM-1. Bacterial cultures and cytology tests were also performed.

Results

The clinical diagnoses were 17 parapneumonic, 14 tuberculous, and 13 malignant effusions. Four patients presented with transudates. The mean ages of the parapneumonic, tuberculous and malignant effusion groups were 57.1±19.7, 49.5±18.6, 66.9±15.5, and 76.0±18.1. respectively. The level of sTREM-1 expression was significantly higher in the parapneumonic effusions (344.0±488.7) than in the tuberculous effusions (81.7±56.6) and malignant effusions (39.3±19.6). With a cut-off value of 55.4pg/ml, the sensitivity and specificity for a parapneumonic effusion was 70.6% and 74.1%.

Conclusion

sTREM-1 expression is significantly higher in parapneumonic effusions, suggesting its potential role as an additional diagnostic marker for pleural effusions.

Keywords: Triggering receptor expressed on myeloid cells, Pleural effusion, Differential diagnosis

Figures and Tables

Figure 1
Flow chart of the diagnosis of the pleural effusions.
trd-62-290-g001
Figure 2
Levels of pleural sTREM-1 among the groups.
*p=0.018, †p=0.008
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Figure 3
ROC curve of pleural sTREM-1 for parapneumonic effusion.
trd-62-290-g003
Figure 4
Correlation of pleural fluid sTREM-1 and pleural fluid PMN count (A), pleural LDH (B) and ADA (C) by Spearman's correlation method.
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Table 1
Clinical characteristics and diagnostic methods among different groups
trd-62-290-i001

*Tuberculous effusion>parapneumonic effusion>malignant effusion.

Table 2
Comparison of chemical properties of pleural fluid among different groups
trd-62-290-i002

*Tuberculous effusion>others, †Parapneumonic effusion<others, ‡Tuberculous effusion>parapneumonic effusion, §Parapneumonic effusion>others, ∥Tuberculous effusion>parapneumonic effusion>malignant effusion.

PF: pleural fluid; LDH: lactate dehydrogenase; PMN: polymorphonuclear leukocyte.

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