tHE DIAGNOSTIC VALUE OF PLEURAL CHOLESTEROL IN [LIE DIFFERENTIATION BETWEEN PLEURAL EXUDATES AND TRANSUDATES
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In the evaluation of pleural effusion , its classification as either exudate or transudate is a first diagnostic step. The aim of this study is to validate the use of pleural cholesterol (PCHOL) and the pleural cholesterol I. serum cholesterol ratio (P/S CHOL) for differentiating between transudates and exudates. The parameters pleural protein (PPROT), pleural protein/serum protein ratio (P/S PROD were compared with ploz.fral cholesterol (PCHOL) and the pleural cholesterol / serum cholesterol ratio (P/S CHOL) with regard to their usefulness for differentiating between pleural exudates and transudates, the PCHOL .values were 34.7±8.9 mg/dl for transudates, 74.2128.5 mg/di for neoplastic exudates, 90.2±14.8mg/dIfor tuberculous exudates and 101.9±25.6 mg/di for parapneumonic exudates. PCHOL values were statistically signcantly (P<0.001) increased in all exudate groups as compared to transudate group. The sensitivity and specificity of PPROT for diagnosis of exudates were both 80% The ..7.7nsftivity and specificity of PS PROT for d.:ai,tuosls afe.i.:‘,„Lzt.,, vvere 82.5% and 90% respectively. All transudates and 5 of the 40 exudates had PCHOL values below 55 mg/dl, so that with this threshold, PCHOL had a sensitivity of 87.5% and a specificity of 100% for diagnosis of exudates. With a threshold of 0.38, P/S CHOL had a sensitivity of 80% and a speccity of 87.5% The number of misclassifications by PCHOL (10%) was less than with any other of the parameters. So it is recommended to measure PCHOL and P/S CHOL routinely in diffirentiation between pleural exudate and pleural transudate.