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Clinical Investigations: PLEURA |

Soluble Leukocyte Selectin in the Analysis of Pleural Effusions*

Lynn Longmore Horvath, CPT, MC, USA; Roger A. Gallup, MAJ, MC, USA; Brian D. Worley, MD, FCCP; Gerald A. Merrill, PhD; Michael J. Morris, LTC, MC, USA
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*From the Pulmonary Disease/Critical Care Service (Drs. Gallup, Worley, and Morris) and Internal Medicine Service (Dr. Horvath), Department of Medicine, and Department of Clinical Investigation (Dr. Merrill), Brooke Army Medical Center, Fort Sam Houston, TX.

Correspondence to: CPT Lynn Longmore Horvath, MC, USA, Department of Internal Medicine Infectious Disease Service, Brooke Army Medical Center, 3851 Roger Brooke Dr, Fort Sam Houston, TX 78234-6200; e-mail: Lynn.Horvath@cen.amedd.army.mil



Chest. 2001;120(2):362-368. doi:10.1378/chest.120.2.362
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Study objectives: To determine if soluble leukocyte selectin (sL-selectin) levels in serum and pleural fluid (PF) are an inflammatory marker that differentiates pleural effusion transudates from exudates.

Design: sL-selectin PF and serum levels were measured in consecutive patients and compared to established criteria.

Setting: A tertiary-care military medical center.

Patients: One hundred twenty patients undergoing diagnostic or therapeutic thoracentesis.

Interventions: PF and serum samples were collected during thoracentesis and analyzed separately for sL-selectin levels. Results were compared with clinical diagnosis and established PF criteria including the criteria of Light et al, cholesterol ratio, total bilirubin ratio, and albumin gradient.

Measurements and results: sL-selectin levels in PF and serum were determined in 109 patients. By clinical diagnosis, mean ± SD PF sL-selectin levels were 200.2 ± 124.3 ng/mL in transudates and 496.8 ± 379.2 ng/mL in exudates (p < 0.001). By the criteria of Light et al, mean PF sL-selectin levels were 195.7 ± 105.2 ng/mL in transudates and 448.2 ± 367.6 ng/mL in exudates (p < 0.001). Mean sL-selectin PF to serum ratios were 0.31 ± 0.17 in transudates and 0.72 ± 0.31 in exudates (p < 0.001) by clinical criteria, and 0.31 ± 0.18 in transudates and 0.64 ± 0.33 in exudates (p < 0.001) by the criteria of Light et al. No significant difference was noted with serum sL-selectin levels between groups.

Conclusions: sL-selectin is an inflammatory marker that differentiates transudates from exudates in pleural effusions and is a sensitive indicator for PF analysis.

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