The Difference Between Carcinomatous and Tuberculous Pleural Fluid in Fibrin and Fibrinogen Metabolism

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  • SUZUKI Setsuko
    Department of Clinical Laboratories, Yokosuka Mutual Aid Hospital
  • KANAYAMA Masaaki
    Department of Internal Medicine, Yokosuka Mutual Aid Hospital
  • MIURA Hirotaro
    Department of Internal Medicine, Yokosuka Mutual Aid Hospital
  • SHIMASE Junji
    Department of Internal Medicine, Yokosuka Mutual Aid Hospital
  • MATSUI Noriaki
    Second Department of Internal Medicine, School of Medicine Tokyo Medical and Dental University

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Other Title
  • 癌性および結核性胸水中に検出されるフイブリン体代謝物質の差異について
  • ガンセイ オヨビ ケッカクセイ キョウスイチュウ ニ ケンシュツサレル フイブ

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Abstract

It is difficult to distinguish the tuberculous pleural fluid from the carcinomatous one by laboratory examination. In this study, the difference between both fluids was investigated from the aspect of coagulation and fibrinolysis.<br>Seventy four samples of pleural fluid and 83 samples of plasma were obtained from patients with carcinomatous pleurisy and 21 samples of pleural fluid and 9 samples of plasma were obtaind from patients with tuberculous pleurisy.<br>On these specimen, the following coagulation and fibrinolytic parameters were measured; high molecular weight fibrinogen/fibrin complex (HMWFC), serial dilution protamine sulfate test (SDPS), ethanol gelation test (EG), fibrin/fibrinogen products (FDP), fibrinogen, coagulation factors (II-XII), α2-macroglobulin (α2-MG), α1-antitrypsin (α1-AT) and antithrombin III (AT III).<br>In Pleural fluid, activities of all coagulation factors were less than 20% of those in plasma, but antigen levels of all coagulation factors were higher than the corresponding activities. In almost all pleural fluids, the concentration of α2-MG and AT III were less than those in plasma, but the concentration of α1-AT was higher than that in plasma.<br>FDP and HMWFC in pleural fleuid were twenty times higher than those in plasma, but significant difference between the tuberculous and carcinomatous pleural fleuids was not revealed.<br>In all tuberculous pleural fluid EG tests was positive. In the carcinomatous pleural fluid, positive incidence of EG test was less than half of the cases. Particularly, EG test was negative in all cases of mesothelioma. From these results, it was suggested that the behavior of paracoagulation tests in pleural fluid had a diagnostic significance for differentiation of pleural diseases.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 22 (2), 186-193, 1981

    The Japanese Society of Hematology

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