Role of pleural fluid interleukin-6, neutrophil-lymphocyte ratio, and monocyte-lymphocyte ratio in distinguishing tuberculous and malignant pleural effusions

Authors

  • Venny Singgih Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ketut Suryana Department of Internal Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ida Ayu Jasminarti Dwi Kusumawardani Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ni Wayan Candrawati Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • I. Gede Ketut Sajinadiyasa Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ida Bagus Ngurah Rai Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20211046

Keywords:

Interleukin-6, Tuberculous pleural effusions, Malignant pleural effusions

Abstract

Background: Pleural effusion is caused by various disease, including tuberculosis infection and malignancy. To determine the etiology, immunologic parameters are needed to distinguish tuberculous and malignant pleural effusions, including pleural fluid interleukin-6 (IL-6), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR).

Methods: This was a cross-sectional study, conducted at Sanglah General Hospital in Denpasar from March 2020 to September 2020. Pleural fluid IL-6 and leucocyte differential count were measured from subjects with tuberculous and malignant pleural effusions.

Results: There were 22 tuberculous pleural effusion subjects with mean pleural fluid IL-6 9269.017±902.211 pg/ml, median (range) pleural fluid NLR 0.123 (0.044-9.449), and MLR 0.065 (0.044-0.355). There were 31 subjects with malignant pleural effusions, with mean pleural fluid IL-6 8212.146±2022.350 pg/ml, median pleural fluid NLR 0.189 (0.015-2.599), and MLR 0.065 (0.010-0.254). Pleural fluid IL-6 in tuberculous pleural effusions were significantly higher (p=0.014). With a pleural fluid IL-6 cut-off ≥9147.959 pg/ml, sensitivity of 63.6% and specificity of 64.5% were obtained. Pleural fluid NLR and MLR of the two groups were not significantly different (p=0.807 and p=0.116).

Conclusions: Pleural fluid IL-6 in tuberculous pleural effusions is higher than malignant pleural effusions, with a cut-off of ≥9147.959 pg/ml, tuberculous pleural effusions can be diagnosed with sensitivity of 63.6% and specificity of 64.5%. There is no difference in pleural fluid NLR and MLR in tuberculous and malignant pleural effusions.

 

 

Author Biographies

Venny Singgih, Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine

Ketut Suryana, Department of Internal Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Internal Medicine, Allergy Immunology Division

Ida Ayu Jasminarti Dwi Kusumawardani, Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine

Ni Wayan Candrawati, Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine

I. Gede Ketut Sajinadiyasa, Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine

Ida Bagus Ngurah Rai, Department of Pulmonology and Respiratory Medicine, Allergy Immunology Division, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine

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Published

2021-03-23

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Original Research Articles