Abstract
In 16 patients with tuberculous pleurisy and 23 patients with carcinomatous pleurisy associated with bronchogenic carcinoma, immuno-biochemical studies were performed on both serum and pleural effusion.
The serum concentrations of IgA, α1-Antitrypsin, Haptoglobin, and Adenosine deaminase (ADA) activity were clearly higher in tuberculosis than in bronchogenic carcinoma, whereas LDH activity was significantly higher in bronchogenic carcinoma than in tuberculosis. Pleural fluid concentrations of LAP, IgA and ADA were significantly higher in tuberculosis than in bronchogenic carcinoma, whereas the concentration of glucose was lower in tuberculosis than in bronchogenic carcinoma. It is considered that measurement of these substances is useful in differentiating tuberculous pleurisy from carcinomatous pleurisy.
The concentration ratios of pleural fluid to serum for most substances examined were similar between tuberculosis and carcinoma. However, the concentration ratios of LAP and ADA were significantly higher in tuberculosis than those in bronchogenic carcinoma. The ratios of GOT, LDH and ADA were greater than 1.0 in both disease. These findings suggest that the elevation of these substances in pleural fluid is attributed to the local production from pleural cavity as the inflammation site. The isoenzyme pattern of GOT and LDH was also analyzed, but there were no differences between tuberculosis and bronchogenic carcinoma.
The concentration ratios of other substances were less than 1.0 and inversely related to their molecular weights. It is suggested that the transfer of substances without local production into pleural fluid from serum was dependent of the size of the molecule.
