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KMID : 0882419930440020147
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Korean Journal of Medicine
1993 Volume.44 No. 2 p.147 ~ p.154
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Changes of Soluble Interleukin-2 Recepter, Interleukin-y and Adenosine Deaminase in Tuberculous Pleural Effusion
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김종혁
정복현/문승환/조호준/이명구/현인구/정기석/남송현/류지소
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Abstract
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ackground : The aim of this study is to evaluate the value of interleukin-6(IL-6),
soluble interleukin-2 receptor (sIL-2R) and adenosine deaminase in diagnosing tuberculos
pleurisy and in differentiating it from malignant pleural effusion, and to find out mutual
relationships between the three paramenters.
Methods : We investigated the level of IL-6, sIL-2R and ADA in various pleural diseases.
Included were 77 subjects with pleural effusion (57 bopsy proven tuberculous pleurisy, 9
malignant pleural effusion, 5 empyema, 4 parapneumonic effusion, 1 paragonimiasis and 1
pancreatitis). IL-6 was measured by Quantikine human IL-6 (R&D systems), sIL-2R by
h-interleukin-2-receptor ELISA (Boehringer Manheim biochemica) and ADA by Giusti's
colorimetric method.
Results : The level of IL-6 was significantly higher in tuberculous effusion (25.593±
17.352pg/ml) than that of malignant effusion (5,800±,485 pg/ml, p<0.001). IL-6 was also
increased in empyema fluids (74,080±8,569 pg/ml). The level of sIL-2R was1 significantly
higher in tuberculous effusion (877±30 pmol/l) than that of 20 nontuberculous effusion (259±
230 pmol/L, p<0.001). The level of ADA was also higher in tuberculous effusion (82.4±6.9
U/L) than that of nontuberculous effustion (18.8±1.6 U/L, p<0.001). Levels of the ADA and
sIL-2R were lower in malignant effusion (16.4±.66 U/L, 229±71 pmol/L) than those of
tuberculous effusion. The sensitivity and specificity of IL-6 in discriminating tuberculosis
from malignancy were 84% and 100%, respectively (cut-off value: 10000 pg/ml). Those of
sIL-2R were 87% and 77% (cut-off value : 350 pmol/L). ADA was most valuable in
differentiating tuberculosis from malignancy, sensitivityand specificity of which were 100%
(cut-off value: 40 U/L). The correlation coefficient of sIL-2R and IL-6 was 0.3822 (p=0.001).
Conclusion : It was suggested that assay of IL-6, sIL-2R and ADA could play an
implemental role in differential diagnosis of tuberculous pleural effusion. Increased level of
the three parameters and significant correlations between them were suggestive of the
involvement of activated T cells in tuberculous pleural effusion.
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KEYWORD
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