结核性与恶性胸腔积液相关生化指标变化及鉴别诊断

doi:10.3969/j.issn.1671-7171.2017.04.009

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Abstract 【Objective】To investigate the changes in biochemical markers between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) for their significance in making differential diagnosis. 【Methods】A total of 92 pleural effusion cases were collected from January 2012 to January 2016 at our hospital. Among them, there were 52 cases of TPE and 40 cases of MPE. At admission, 5ml of pleural effusions was harvested by pleural biopsy. Routine examination of pleural effusion (white blood cells, lymphocytes, neutrophils, eosinophils, mesothelial / tissue cells, total protein, lactate dehydrogenase, glucose) and cytokines [IL-1β, IL-10, IL-13, IFN-gamma, chemokines interferon inducible protein 10 (IP-10), basic fibroblasts Cell growth factor (bFGF)]were tested. 【Results】The number of white blood cells in pleural effusion was significantly higher in TPE patients than in MPE patients (P<0.05). However, in MPE and TPE patients, the number of pleural effusion lymphocytes, neutrophils, eosinophils, mesothelial, Lactate dehydrogenase (LDH) and glucose were not statistically significant. The levels of IL-1β, IP-10, IL-13 and IFN-γ in tuberculous pleural effusion were significantly higher than those in malignant pleural effusion. The level of bFGF in malignant pleural effusion was significantly higher than that in tuberculous pleural effusion. There were no significant differences in IL-10 levels in both pleural fluids. ROC curve analysis showed that when the optimal thresholds were 5.5 pg/mL for IL-1β, 4005 pg/mL for IP-10, 7.9 pg/mL for IL-13, 100.5 pg/mL for IFN-γ and 2.4 pg/mL for bFGF (P<0.05), which was valuable in the diagnosis of tuberculous and malignant pleural effusion. 【Conclusion】The changes of IL-1β, IP-10, IL-13, IFN-γ and bFGF have important differential diagnostic value in tuberculous and malignant pleural effusion.

Key words： Pleural Effusion, Malignant Tuberculosis, Pleural/CO Pleural Effusion/ET Diagnosis, Differential Interleukins

Received: 05 September 2016

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R561.3

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	ZHANG Ning
	WANG Ke
	ZHANG Xia

Cite this article:

ZHANG Ning,WANG Ke,ZHANG Xia. Changes and Differential Diagnosis of Biochemical Markers related to Tuberculous and Malignant Pleural Effusion[J]. JOURNAL OF CLINICAL RESEARCH, 2017, 34(4): 651-654,657.

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2017.04.009 OR http://www.jcr.net.cn/EN/Y2017/V34/I4/651

[1] 凡瞿明, 张国元, 刘剑平,等. 结核性及恶性肿瘤性胸腔积液淋巴细胞亚群比例以及Th1/Th2免疫平衡研究[J]. 第三军医大学学报, 2008, 30(18):1749-1752.
[2] 陈江帆, 杜明伟, 姜海娇,等. 免疫细胞化学方法对胸腔积液中恶性肿瘤细胞的分类与诊断[J]. 中国组织化学与细胞化学杂志, 2013, 22(1):49-53.
[3] 周晓明, 李光, 冯学威, 等. 胸腔积液脱落细胞检查在胸膜转移性肺腺癌和恶性间皮瘤所致胸腔积液鉴别诊断中的价值[J].医学临床研究, 2012,29(7):1244-1249.
[4] American Thoracic Society. Management of malignant pleural effusions[J].Am J Respir Crit Care Med. 2000;162(5):1987-2001.
[5] Duysinx BC, Corhay JL, Hubin L,et al.Diagnostic value of interleukine-6, transforming growth factor-beta 1 and vascular endothelial growth factor in malignant pleural effusions[J].Respir Med,2008,102(12):1708-1714. [6] Momi H, Matsuyama W, Inoue K, et al. Vascular endothelial growth factor and proinflammatory cytokines in pleural effusions[J]. Respir Med,2002,96(10):817-822.
[7] Li X, Zhou Q, Yang WB, et al. Pleural mesothelial cells promote expansion of IL-17-producing CD8⁺ T cells in tuberculous pleural effusion[J]. J Clin Immunol,2013,33(4):775-787.
[8] Klimiuk J, Safianowska A, Chazan R, et al. Development and evaluation of the new predictive models in tuberculous pleuritis[J]. Adv Exp Med Biol, 2015,873:53-63.
[9] Shu CC, Wang JY, Hsu CL, et al. Diagnostic role of inflammatory and anti-inflammatory cytokines and effector molecules of cytotoxic T lymphocytes in tuberculous pleural effusion[J]. Respirology,2015,20(1):147-154.
[10] Dheda K, Van-Zyl Smit RN, Sechi LA, et al. Clinical diagnostic utility of IP-10 and LAM antigen levels for the diagnosis of tuberculous pleural effusions in a high burden setting[J]. PLoS One,2009,4(3):e4689.
[11] 肖玲,温武金,辜海文,等. Th细胞免疫与结核性胸膜炎胸膜粘连关系的研究[J].中国实用内科杂志, 2008,28(2):116-120.
[12] Wei M, Wu ZY, Lin JH, et al. Regulation network of serum cytokines induced by tuberculosis-specific antigens reveals biomarkers for tuberculosis diagnosis[J]. Genet Mol Res,2015,14(4):17182-17192.
[13] Xiao XY, Lang XP. Correlation Between MMP-7 and bFGF Expressions in Non-small Cell Lung Cancer Tissue and Clinicopathologic Features[J]. Cell Biochem Biophys,2015 ,73(2):427-432.
[14] Hsu IL, Su WC, Yan JJ, et al. Angiogenetic biomarkers in non-small cell lung cancer with malignant pleural effusion: correlations with patient survival and pleural effusion control[J]. Lung Cancer, 2009,65(3):371-376.
(本文编辑:邓丽萍) [收稿日期] 2016-09-05