白细胞介素-33 在胸腔积液（尤其是结核性和恶性胸腔积液）鉴别诊断中的作用。

Diagnostic role of interleukin -33 in the differentiation of pleural effusions especially tuberculous and malignant effusions.

机构信息

Faculty of medicine, Benha University, Banha city, Qalubia Province, 13518, Egypt.

Faculty of medicine, Kafrelsheikh University, fifth foutoh salam street, Banha city, Qalubia Province, 13518, Egypt.

出版信息

BMC Pulm Med. 2019 Jun 25;19(1):114. doi: 10.1186/s12890-019-0874-y.

DOI:10.1186/s12890-019-0874-y

PMID:31238901

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6593576/

Abstract

BACKGROUND

Tuberculous pleurisy and malignancy are two of the most common causes of pleural effusion. IL-33 is expressed in the epithelial lining and endothelial cells and is released after cell damage; it is proposed to have an essential role in sensing damage in various infectious and inflammatory diseases. This work aimed to determine the diagnostic role of IL-33 in pleural effusions.

METHODS

One hundred seventeen patients with pleural effusions of different etiologies had a quantitative measurement of IL-33 in their pleural effusion and serum samples by ELISA technique.

RESULTS

The concentrations of IL-33 (mean ± SD) in tuberculous pleural effusion (TPE) group (22.5 ± 0.90 ng/l) were significantly higher than that of malignant pleural effusion (MPE) group (14.6 ± 2.35 ng/l; P < 0.001). There is no significant difference between the serum levels of IL-33 in (TPE) group and (MPE) group (P > 0.05). The concentrations of IL-33 in the pleural effusions were significantly correlated to that of the serum concentrations in each group (TPE: r = 0.848, P = < 0.001; MPE: r = 0.881, < 0.001) and pleural ADA in patients with tuberculous pleural effusions, (r = 0.38, P < 0.001). The cut-off value of pleural IL33 for (TPE) was 19.16 ng/l, with a sensitivity of 91.7%, a specificity of 96.4%. The cutoff point of a pleural/ serum IL-33 ratio for the diagnosis of TPE was > 1.4 with a sensitivity of 91.7% and specificity of 100% while for the determination of (MPE) was < 0.9 with a sensitivity of 83.3% and specificity of 96.4%.

CONCLUSION

IL-33 level may serve as a novel biomarker to differentiate pleural effusions, especially tuberculous from malignant effusions.

摘要

背景

结核性胸膜炎和恶性肿瘤是胸腔积液的两个最常见原因。IL-33 在内皮细胞和上皮细胞中表达，在细胞损伤后释放，被认为在各种感染性和炎症性疾病的损伤检测中具有重要作用。本研究旨在确定 IL-33 在胸腔积液中的诊断作用。

方法

采用 ELISA 技术对 117 例不同病因胸腔积液患者的胸腔积液和血清样本进行 IL-33 的定量检测。

结果

结核性胸腔积液（TPE）组（22.5±0.90ng/l）IL-33 浓度明显高于恶性胸腔积液（MPE）组（14.6±2.35ng/l；P<0.001）。（TPE）组和（MPE）组血清中 IL-33 水平无显著性差异（P>0.05）。各组胸腔积液中 IL-33 浓度与血清浓度呈显著正相关（TPE：r=0.848，P<0.001；MPE：r=0.881，P<0.001），且与结核性胸腔积液患者胸腔 ADA 呈正相关（r=0.38，P<0.001）。胸腔 IL33 对 TPE 的截断值为 19.16ng/l，灵敏度为 91.7%，特异性为 96.4%。胸腔/血清 IL-33 比值对 TPE 的诊断截断值>1.4，灵敏度为 91.7%，特异性为 100%；对 MPE 的诊断截断值<0.9，灵敏度为 83.3%，特异性为 96.4%。