Background: Pleural effusions are caused by a wide variety of diseases. It is
important to elucidate their precise etiologies to differentiate benign from malignant
effusions. The polyamines are important molecules governing cell proliferation,
survival and apoptosis. Consistent with their elevated levels in cancer, it seemed
probable that patients with active cancer might have elevated levels of these
compounds in some of their body fluids. The aim of the present study was to
investigate the diagnostic efficacy of measuring pleural effusion concentration of the
polyamines (putrescine, spermidine, and spermine) for discrimination of malignant
and benign pleural effusions. Patients and Methods: Pleural effusions were collected
from 138 consecutive patients in whom the diagnosis was confirmed with cytological
and/or histological examinations. Cytological samples were classified as malignant
(n=78) and benign (n=60). Polyamines concentrations were measured using the ion
exchange chromatography method. Results: The results showed that the levels of the
three polyamines were significantly higher in malignant pleural effusions when
compared to the benign effusions. Conclusion: The polyamines putrescine,
spermidine, and spermine are of great value in the diagnosis of malignancy and may
be used as an adjunct to cytological findings in determining malignant pleural
effusions.