Chan Ming-Cheng, Chang Kai-Ming, Chao Wen-Cheng, Lin Liang-Yi, Kuo Benjamin Ing-Tiau, Hsu Jeng-Yuan, Wu Chieh-Liang
Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, and Central Taiwan University of Science and Technology, Taipei, Taiwan.
Respirology. 2007 May;12(3):333-8. doi: 10.1111/j.1440-1843.2007.01056.x.
The triggering receptor expressed on myeloid cell-1 (TREM-1) is a newly discovered molecule that is associated with the inflammatory response to microorganisms. We investigated the role of surface and soluble TREM-1 in differentiating different disease entities in pleural effusion formation.
Sixty-seven patients with pleural effusion due to transudate (14), malignancy (15), tuberculous pleuritis (16), para-pneumonic effusion (10) and empyaema (12) were included in this study. Surface TREM-1 was measured by flow cytometry and was expressed as mean fluorescence intensity and soluble TREM-1 was measured by ELISA and expressed as pg/mL. Results are given as mean levels +/- SEM.
Surface TREM-1 was measured in 24 patients and the levels were highest in para-pneumonic effusion (30.0 +/- 8.4) and lowest in malignant pleural effusion (5.2 +/- 1.1) and tuberculous pleuritis (5.2 +/- 2.4). Soluble TREM-1 was highest in effusions of infectious aetiology (para-pneumonic effusion (979.4 +/- 229.6) and empyaema (1712.6 +/- 299.5)) and lowest in non-infectious effusions (transudate (81.2 +/- 4.5 pg/mL) and malignancy (111.3 +/- 20.7). At a cut-off value of 114 pg/mL, soluble TREM-1 yielded a sensitivity of 87.5% and a specificity of 89.7% in differentiating non-infectious effusion from tuberculous pleuritis. At a cut-off value of 374 pg/mL, sTREM-1 yielded a sensitivity of 93.8% and a specificity of 90.9 in differentiating tuberculous pleuritis from bacterial pleural effusion.
Soluble and surface TREM-1 are valuable markers in establishing the aetiology of pleural effusions.
髓样细胞触发受体-1（TREM-1）是一种新发现的与微生物炎症反应相关的分子。我们研究了表面TREM-1和可溶性TREM-1在鉴别胸腔积液形成中不同疾病实体的作用。
本研究纳入了67例因漏出液（14例）、恶性肿瘤（15例）、结核性胸膜炎（16例）、类肺炎性胸腔积液（10例）和脓胸（12例）导致胸腔积液的患者。通过流式细胞术检测表面TREM-1，以平均荧光强度表示；通过ELISA检测可溶性TREM-1，以pg/mL表示。结果以平均水平±标准误给出。
对24例患者检测了表面TREM-1，类肺炎性胸腔积液中的水平最高（30.0±8.4），恶性胸腔积液（5.2±1.1）和结核性胸膜炎（5.2±2.4）中的水平最低。可溶性TREM-1在感染性病因所致胸腔积液中最高（类肺炎性胸腔积液（979.4±229.6）和脓胸（1712.6±299.5）），在非感染性胸腔积液中最低（漏出液（81.2±4.5 pg/mL）和恶性肿瘤（111.3±20.7））。可溶性TREM-1在鉴别非感染性胸腔积液与结核性胸膜炎时，截断值为114 pg/mL时，敏感性为87.5%，特异性为89.7%。在鉴别结核性胸膜炎与细菌性胸腔积液时，截断值为374 pg/mL时，可溶性TREM-1的敏感性为93.8%，特异性为90.9%。
可溶性和表面TREM-1是确定胸腔积液病因的有价值标志物。
