Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sci Rep. 2021 Jan 12;11(1):660. doi: 10.1038/s41598-020-79685-1.
Patients with tuberculous pleural effusion (TPE) or malignant pleural effusions (MPE) frequently have similar pleural fluid profiles. New biomarkers for the differential diagnosis of TPE are required. We determined whether cytokine profiles in the PE of patients could aid the differential diagnosis of TPE. 30 patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP) and 14 patients with parapneumonic effusion (PPE) were enrolled between Dec 2018 and 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL8, CCL-1 and IP-10 were determined in PE by ELISA along with measurements of adenosine deaminase (ADA). The best predictors of TPE were combined ADA.IL-27 [optimal cut-off value = 42.68 (10 U ng/l), sensitivity 100%, specificity 98.28%], ADA [cut off value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] and IL-27 [cut-off value = 2363 (pg/ml), sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001]. A high level of IL-6 [cut-off value = 3260 (pg/ml), sensitivity 100%, specificity 67.2%], CXCL8 [cut-off value = 144.5 (pg/ml), sensitivity 93.3%, specificity 58.6%], CCL1 [cut-off value = 54 (pg/ml), sensitivity 100%, specificity 70.7%] and IP-10 [cut-off value = 891.9 (pg/ml), sensitivity 83.3%, specificity 48.3%] were also predictive of TPE. High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy and may be useful clinically.
结核性胸腔积液（TPE）或恶性胸腔积液（MPE）患者的胸腔积液特征通常相似。需要新的生物标志物来辅助 TPE 的鉴别诊断。我们旨在确定胸腔积液中的细胞因子谱是否有助于 TPE 的鉴别诊断。2018 年 12 月至 2019 年期间，纳入了 30 例 TPE 患者、30 例 MPE 患者、14 例脓胸（EMP）患者和 14 例类肺炎性胸腔积液（PPE）患者。通过 ELISA 测定胸腔积液中白细胞介素（IL）-6、IL-18、IL-27、CXCL8、CCL-1 和 IP-10 的水平，并测定腺苷脱氨酶（ADA）。TPE 的最佳预测指标为联合 ADA.IL-27[最佳截断值为 42.68（10 U ng/l），敏感性 100%，特异性 98.28%]、ADA[截断值 27.5（IU/l），敏感性 90%，特异性 96.5%]和 IL-27[截断值为 2363（pg/ml），敏感性 96.7%，特异性 98.3%，p≤0.0001]。高水平的 IL-6[截断值为 3260（pg/ml），敏感性 100%，特异性 67.2%]、CXCL8[截断值为 144.5（pg/ml），敏感性 93.3%，特异性 58.6%]、CCL1[截断值为 54（pg/ml），敏感性 100%，特异性 70.7%]和 IP-10[截断值为 891.9（pg/ml），敏感性 83.3%，特异性 48.3%]也提示 TPE。高 ADA.IL-27、ADA 和 IL-27 水平可改善 TPE 和非 TPE 的鉴别诊断的特异性和准确性，可能具有临床应用价值。
