Fibrinolytic characteristics and their significance in malignant, tuberculous and cirrhotic pleural and ascitic fluids

Abstract

The fibrinolytic characteristics and clinical pathological significance of pleural and ascitic fluid were studied in patients with malignant tumour, tuberculosis or liver cirrhosis. Urokinase plasminogen activator (uPA) and urokinase plaminogen activator receptor (uPAR) levels were measured by enzyme-linked immunoadsorbent assay and tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), plasminogen (Plg), plasmin (Pl) and alpha(2) plasmin inhibitor (alpha(2)PI) by colorimetric assay. uPA and uPAR levels were higher in malignant tumour and tuberculosis compared with liver cirrhosis, whereas tPA levels were significantly higher in liver cirrhosis and malignant tumour than in tuberculosis patients. Tuberculosis patients showed statistically higher PAI-1, Plg and Pl concentrations than malignant tumour patients, which, in turn, were higher than those in liver cirrhosis patients. alpha(2)PI levels were markedly higher in malignant tumour and liver cirrhosis than in tuberculosis. In the malignant tumour group, only uPA level was significantly different between the samples that contained cancer cells and those that did not. We found significant differences between the fibrinolytic characteristics in pleural and ascitic fluid in patients with malignant tumour, tuberculosis and liver cirrhosis. The analysis of several fibrinolytic parameters could help to determine the quality of pleural and ascitic fluid, and also to further understand the pathological processes of these diseases.

Age and sex distribution in malignant and tuberculous serous effusions: A study of 127 patients and review of the literature

“…However, the difference in the male‐to‐female ratio between tuberculosis and non‐tuberculous benign lesions was not significant ( P = 0.42756). A similar trend was observed when the various studies from the review of the literature were taken into consideration (Table ); the malignancy patients (male : female = 730:649 with females accounting for 47.1%) were significantly different from tuberculosis patients (male : female = 656: 342 with females accounting for 35.7%, P = 0.00000) as well as non‐tuberculous benign cases (male : female = 232:129, P = 0.00014). However, the difference between tuberculosis and non‐tuberculous benign lesions was not significant ( P = 0.65151).…”

“…Whereas tuberculous serous effusion was mostly a disease of those aged <40 years, malignant effusion was a commonly found in the ≥50 years age group. A review of the literature (Table ) shed light on age and sex distribution in 13 studies that were based on pleural effusion and ascitic fluids involved by malignancy and tuberculous processes and six studies in which malignancy, tuberculosis and non‐tuberculous benign lesions presented with serous effusions . In all these 19 studies, the mean and/or median age of malignancy patients were ≥50 years, as opposed to tuberculous pleurisy cases in which the mean/median age was ≥50 years in just eight patients ( P = 0.00006).…”

Plasmin enhances cell surface tissue factor activity in mesothelial and endothelial cells

“…Pleural inflammation leads to increased microvascular permeability with formation of exudative effusions that contain plasma constituents. Albumin is the principal protein present in exudative pleural effusions, but coagulation and fibrinolytic proteins are also well represented in pleural effusions [4,10–15]. Although active thrombin or plasmin was difficult to detect in most of the pleural fluids [4], there was a strong indication that they were generated in the pleural space.…”

“…Pleural inflammation leads to increased microvascular permeability with formation of exudative effusions that contain plasma constituents. Albumin is the principal protein present in exudative pleural effusions, but coagulation and fibrinolytic proteins are also well represented in pleural effusions [4,[10][11][12][13][14][15].…”

Host–Pathogen Interactions in Tuberculosis

“…Lu and collaborators, compared the concentration of components of fibrinolytic system in pleural and ascytic fluid from tuberculosis, cancer and liver cirrhosis patients, the results showed higher levels of uPA and uPAR from tuberculosis and cancer patients with respect to cirrhosis patients, whereas tPA level was higher in cancer and cirrhosis patients than tuberculosis patients. PAI-1, Plg and Plm levels in tuberculosis patients where statistically higher than those levels in cirrhosis and cancer patients (Lu et al, 2007).…”