Quantitative C-reactive protein for differentiating tuberculous and malignant pleural effusion: A cross-sectional...

Area of Science:

• Pulmonology
• Oncology
• Infectious Diseases

Background:

• Lymphocyte-rich pleural effusion is commonly caused by tuberculosis and malignancy.
• Diagnosing pleural effusion in resource-limited settings presents challenges.
• A simple diagnostic test is needed to differentiate causes of pleural effusion.

Purpose of the Study:

• To evaluate the diagnostic utility of quantitative C-reactive protein (qCRP) for differentiating tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE).

Main Methods:

• A cross-sectional study involving 81 patients with lymphocyte-rich exudative pleural effusion.
• Biochemical analyses of pleural fluid qCRP levels and pathological examinations.
• Statistical analysis including t-test, chi-square test, multivariate logistic regression, and ROC curve analysis.

Main Results:

• Tuberculous pleural effusion (TPE) showed significantly higher pleural fluid qCRP levels (55.5 mg/L) compared to malignant pleural effusion (MPE) (18.6 mg/L).
• A pleural fluid CRP cutoff of ≥24.1 mg/L demonstrated 65.9% sensitivity and 73.5% specificity for predicting TPE.

Conclusions:

• Pleural fluid qCRP is a valuable tool for differentiating TPE from MPE.
• The test is simple, rapid, and cost-effective.
• qCRP aids in diagnosing lymphocyte-rich exudative pleural effusion in challenging environments.