The aim of this study was to examine the role of TLR2 molecule in pleural space during thoracoscopic talc pleurodesis period in patients with malignant pleural effusion. We analyzed TLR2 molecule in soluble form as well as on membrane of granulocytes in pleural fluid. Pleural fluid examination was done at three intervals during pleurodesis procedure: 1st—before the thoracoscopic procedure, 2nd—2 hours after the terminating thoracoscopic procedure with talc insufflation, 3rd—24 hours after the thoracoscopic procedure. We reported significant increase of soluble TLR2 molecule in pleural fluid effusion during talc pleurodesis from preoperative value. This increase was approximately 8-fold in the interval of 24 hours. The changes on granulocyte population were quite different. The mean fluorescent intensity of membrane TLR2 molecule examined by flow cytometry on granulocyte population significantly decreased after talc exposure with comparison to prethoracoscopic density. To estimate the prognostic value of TLR2 expression in pleural fluid patients were retrospectively classified into either prognostically favourable or unfavourable groups. Our results proved that patients with favourable prognosis had more than 3-fold higher soluble TLR2 level in pleural fluid early, 2 hours after talc pleurodesis intervention. 1. Introduction Pleural effusion is a frequent complication in many types of tumors [1]. Although there are more than 50 recognized causes of pleural effusion formation, malignancy, infection, heart failure, and pulmonary embolism are the most common reasons for pleural effusion development [2, 3]. Normally, the fluid volume is small in pleural space. It contains approximately 1？mL of fluid with the absence of inflammatory cells [2, 4]. Inflammatory changes can be initiated by penetration of foreign cells (tumor cells or microbes), proteins, or air as well as mechanical invasion [4]. Pleural effusions are either transudates or exudates reflecting the way of origin, detectable by biochemical analysis mostly by pleural fluid protein concentration and lactate dehydrogenase (LDH) level [3, 5]. The malignant pleural effusions are mainly of exudative character with hallmarks of an inflammatory process but exact mechanism of pleural fluid accumulation is not fully understood [4, 6, 7]. The treatment of malignant pleural effusion is always local and palliative [1]. This therapy is based on application of sclerosing agent into the pleural cavity to achieve a symphysis between the visceral and parietal pleura [8]. This approach is called chemical pleurodesis
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