Diagnostic value of ferritin in malignant pleural and peritoneal effusions

Abstract

The diagnostic usefulness of ferritin measurements in pleural and peritoneal effusions has been evaluated in 57 patients. Mean (+/- standard error [SE]) ferritin levels were 291 +/- 50 ng/ml in 24 patients with noninflammatory transudates (Group I), 942 +/- 253 in 15 patients with nonmalignant exudates (Group II), and 1805 +/- 257 in 18 patients with malignant exudates (Group III). The mean (+/- SE) ratio of effusion/serum ferritin in Groups I, II, and III was 0.7 +/- 0.1, 2.7 +/- 0.7, and 5.7 +/- 1.2, respectively. The specificity and predictive value of a ferritin ratio in excess of 1.5 in distinguishing transudates from all exudates and in distinguishing transudates from malignant exudates were both very high (94%) to 96%). In the lower range of values considerable overlap existed between ferritin ratios obtained in patients with benign versus malignant inflammatory exudates. However, very high ferritin levels (greater than 3000 ng/ml) and ferritin ratios (greater than 20:1) were only encountered in malignant exudates. These results indicate that the measurement of ferritin levels and ferritin ratios may be a useful aid in the diagnosis of malignant pleural and peritoneal effusions.

Biochemical analysis of pleural fluid: what should we measure?

“…72,73 Pleural uid ferritin concentrationand¯uid:serum ferritin ratios have been suggested as distinguishing transudates from exudates, particularly in the diagnosis of malignant exudates, where very high concentrations may be seen. 51,74 Others have not found ferritin to be so useful. 49,75 Fibrin degradation products have been reported to be increased in patients with malignancy, pulmonary embolus and infected exudates.…”

Μελέτη Των Κυτταροκινών Του Πλευριτικού Υγρού

“…Επιπρoσθέτως, έχουν βρεθεί αυξηµένα τα επίπεδα του παράγοντα νέκρωσης όγκου (TNF-a), της ιντερλευκίνης-1β (IL-1β), της ιντερλευκίνης-2 (IL-2), του υποδοχέα της ιντερλευκίνης-2 παρούσα µελέτη αποτελείται από δύο επιµέρους σκέλη. Η πρώτη µελέτη βασίστηκε στην δυσκολία που υπάρχει στην καθηµερινή κλινική πρακτική για την ταυτοποίηση της υπεζωκοτικής συλλογής[88][89][90][91][92][93][94][95][96][97] .Ηρακλείου. Η µέση ηλικία των ασθενών που πληρούσαν κριτήρια εισαγωγής στη µελέτη ήταν 65 έτη (εύρος 32-92 έτη),71 άνδρες και 29 δύο ασθενείς ήταν χρόνια νεφρική ανεπάρκεια και σε δύο ασθενείς η κίρρωση του ήπατος.…”