Department of Respiratory and Critical Care Medicine, The Fifth People's Hospital of Jingdezheng City, Jingdezheng, China.
Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Jingdezheng City, Jingdezheng, China
Ann Clin Lab Sci. 2024 Mar;54(2):201-210.
Malignant pleural effusion (MPE) is a common complication of lung cancer with poor prognosis. Benign pleural effusion (BPE), such as tuberculous and pneumonic pleural effusion, usually has a good prognosis. Differential diagnosis between MPE and BPE remains a clinical challenge.
52 MPE, 93 BPE, and their corresponding serum samples were analyzed by hydrogen nuclear magnetic resonance (HNMR) based metabolomics.
The HNMR study showed that some amino acids and betaine in MPE are significantly altered in pleural effusion and serum compared to BPE patients. Levels of serum glucose and glutamine have strong positive correlation with those in pleural effusion (r>0.6) for MPE patients. The area under the receiver operating characteristic curve (AUROC) values of metabolites in pleural effusion or serum were less than 0.805 in differentiating MPE from BPE. Improved an AUROC value of 0.901 was observed using pleural effusion-serum ratios of glutamic acid in differentiating MPE from BPE, which was further validated by 15 double-blind samples.
Compared with BPE patients, amino acids and betaine in MPE are significantly altered in pleural effusion and serum. Pleural effusion-serum ratio of glutamic acid may contribute to the rapid diagnosis of MPE from BPE by HNMR analysis.
恶性胸腔积液（MPE）是肺癌的常见并发症，预后不良。良性胸腔积液（BPE），如结核性和肺炎性胸腔积液，通常预后良好。MPE 和 BPE 的鉴别诊断仍然是临床挑战。
对 52 例 MPE、93 例 BPE 及其相应的血清样本进行基于氢核磁共振（HNMR）的代谢组学分析。
HNMR 研究表明，与 BPE 患者相比，MPE 患者胸腔积液和血清中的一些氨基酸和甜菜碱明显改变。MPE 患者血清葡萄糖和谷氨酰胺水平与胸腔积液中的水平呈强正相关（r>0.6）。区分 MPE 和 BPE 时，胸腔积液或血清中代谢物的受试者工作特征曲线（AUROC）值小于 0.805。使用区分 MPE 和 BPE 的胸腔积液-血清谷氨酸比值可提高 AUROC 值至 0.901，这在 15 个双盲样本中得到了进一步验证。
与 BPE 患者相比，MPE 患者胸腔积液和血清中的氨基酸和甜菜碱明显改变。HNMR 分析显示，胸腔积液-血清谷氨酸比值可能有助于快速诊断 MPE 与 BPE。
