الفهرس 
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Abstract
Pleural effusion is the result of an imbalance between excessive pleural fluid
formation and pleural fluid absorption.
The diagnosis of pleural effusion is very difficult, identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments.
Pleural fluid is classified as transudate or exudate according to its composition and underlying pathophysiology.
Transudates are usually the result of systemic factors that influence the formation and absorption of pleural fluid. They are usually caused by conditions other than the lung and pleura, on the other hand, exudates are the result of pleural or pulmonary processes that lead to pleural fluid accumulation, they are the result of local disease.
There are many laboratory tests that could help to separate exudative from transudative effusion. The most accepted and valid criteria for the diagnosis of pleural exudates are called Light’s criteria.
No diagnosis is ever established for approximately 15% of patients with pleural effusion even after use of invasive procedures as thoracoscopy.
The development of disease-specific diagnostic biomarkers for pleural effusions is an active area of research. Increasing numbers of biomarkers have been incorporated into clinical care.
Osteopontin (OPN) is an important mediator of inflammation and cancer progression.
The aim of this research is to determine the level of serum and pleural osteopontin in order to differentiate between exudative and transudative pleural effusions and to differentiate between tuberculous, malignant and parapneumonic effusions.
In the present study, forty cases with pleural effusion of different etiologies from Chest Department of the Main Alexandria University Hospital and El Maamoura Hospital were selected with ten healthy subject as a control group in whom serum osteopontin was assessed.
All patients and the con