A Comparative Study on Mean Levels of Amylase in Pleural and Peritoneal Effusions and Ratio of Pleural Peritoneal Fluid Amylase to Serum Amylase in Patients With Malignant Effusion and Reactive Effusion



Moghaddam NA¹ ; Akbari P² ; Solouki R² Show Affiliations
Source: Journal of Isfahan Medical School Published:2011

Abstract

Background: Routine measurement of pleural and peritoneal fluid amylase is frequently recommended. However, the efficiency of this method is still unknown. Methods: In order to find out the practical value of routine measurements of pleural and peritoneal amylase and serum fluid in the evaluation of pleural and peritoneal effusions, amylase level was measured in the fluids and serum by the kinetics method (amyloclastic) and an alpha-amylase kit in 176 patients undergoing thoracentesis and peritoneocentesis during an 18-month period (from March 2010 to September 2011). These patients were divided into a group with malignant effusion and another group with reactive effusion. There were 122 patients with effusions after malignancy, 44 with effusions following benign diseases, and 10 with effusions of unknown origin. Infectious and inflammatory effusions were excluded from our study. Findings: Measurement of amylase levels in serous and serum fluid was not effective in determining the origin of effusions in any of the patients. Amylase levels greater than 160 IU/L (upper than normal level) existed only in 12 patients out of 176 subjects (6%) with 13.6% being in the malignant effusion group. Moreover, there was no correlation between malignant effusion and serum amylase level (P = 0.73). Conclusion: Routine measurement of amylase levels in pleural and peritoneal fluid is not clinically important because although the average amylase level of serous fluid in the malignant effusion group was higher than the normal level in the reactive effusion group, it was not statistically significant (P = 0.08). © 2011, Isfahan University of Medical Sciences(IUMS). All rights reserved.