Soluble interleukin-2 receptor (sIL-2R) has been known as a sensitive marker of
T-lymphocyte activation. Because T-cell activation is important in the pathogenesis of
tuberculosis, especially in the pleural effusion, a high level of sIL-2R is expected in the
serum and pleural fluid of the patients with tuberculosis. Sometimes the differential
diagnosis between tuberculous pleurisy and malignant pleural effusion is sometimes very
difficult clinically, so to look at the diagnostic value of sIL-2R in the differentiation of
these two diseases, we measured the sIL-2R level of the sera and pleural fluids of 33
patients with pathologically and/or bacteriologically proven tuberculous pleurisy and 17
patients with malignant effusion diagnosed by pleural biopsy and/or pleural fluid
cytology. We found that:
1) Even though the serum level of sIL-2R of the patients with tuberculous pleurisy :
1325±490 U/㎖ was significantly higher than the level of malignant pleural effusion:852
±381 U/㎖ (P<0.05), there was a wide range of overlapping between the two groups.
2) In the pleural fluid, the sIL-2R level of. tuberculous pleurisy : 6963±2199 U/㎖ was
much higher than that of malignant effusion : 1684±684 U/㎖ (P<0.005), and no
overlapping of the individual values between the two groups was noted.
3) About two or three months after the initiation of antituberculous medication, the
serum sIL-2R level of the tuberculous pleural effusion returned to the normal range.
We conclude that the level of sIL-2R in the pleural fluid is useful in the differential
diagnosis between the two diseases.
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