Tumor necrosis factor-alpha, decoy receptor-3, ficolin-2, presepsin and heat shock protein 70 in pleural effusions

BACKGROUND: The aim of this study was to evaluate the pleural fluid tumor necrosis factor-alpha (TNF-alpha), decoy receptor-3 (decoy R3), ficolin-2, presepsin and heat shock protein 70 (HSP70) in the differential diagnosis of effusions and we tried to evaluate markers that distinguish tuberculosis pleural effusions (TPE) from malignant pleural effusions (MPE). METHODS: The study group was divided into four groups with 19 TPE, 27 parapneumonic effusions (PPE), 20 MPE and 23 transudative pleural effusions. TNF-alpha, decoy R3, ficolin-2, presepsin and HSP70 was studied through ELISA method. RESULTS: Pleural fluid TNF-alpha, HSP70, decoy R3 levels were significantly higher in exudates than transudate (P=0.000, P=0.003 and P=0.000). There was no significant difference between transuda and exudate groups in terms of ficolin-2 and presepsin (P=0.357 and P=0.598). The fluid levels of TNF-alpha, decoy R3 and HSP 70 were significantly higher in tuberculosis-related fluids than in MPEs (P=0.015, P=0.001 and P=0.000). Pleural fluid ficolin-2 level was statistically significantly lower in TPEs in tuberculosis-non-tuberculosis fluid separation and tuberculosis-malignant fluid separation (P=0.001 and P=0.001). CONCLUSIONS: Our study indicated that an increase in pleural fluid TNF-alpha, HSP70, decoy R3 concentrations and a decrease in ficolin-2 concentration may have important role in distinguishing tuberculosis pleural effusions from non-tuberculosis and malignant pleural effusions.