Wang Lin, Qi Ying, Nan Yan, Qi Suhong
Department of Tuberculosis, Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Pneumology Department, Baoding People's Hospital, Baoding, Hebei, China.
Medicine (Baltimore). 2024 Nov 22;103(47):e40375. doi: 10.1097/MD.0000000000040375.
This study examines the diagnostic utility of the combined interleukin-33 (IL-33), interferon-γ (IFN-γ), and interleukin-35 (IL-35) test in tuberculous pleural effusion. Forty patients with pleural effusion of unknown etiology admitted to the hospital between December 2020 and December 2023 were selected as the study group. The patients were further categorized into tuberculous (TB) (n = 20) and malignant (n = 20) groups on the basis of their relevant data, while sera from 20 healthy medical checkups were used as control group. Thoracentesis was used to collect pleural fluid, and after its collection, enzyme-linked immunosorbent assay was utilized to detect the concentration content of IL-35, IL-33, and IFN-γ in pleural fluid of patients with different types of diseases. Data processing and analysis were executed through SPSS23.0 software to plot the receiver operating characteristic curve and compare the area of the area under the line of each index. Adenosine deaminase level was statistically higher in TB group patients (59.91 U/L) than in malignant group (14.31 U/L) (P < .05). Pleural fluid lactate dehydrogenase levels did not differ significantly between the 2 groups (P > .05). T-SPOT test had a higher positive rate in the TB group (85%) and a lower positive rate in the malignant group (45%). The TB group exhibited significantly higher levels of IFN-γ expression than the malignant group (P < .05). The TB group had higher levels of IL-33 and IL-35 compared to the malignant group, with a statistically significant difference (P < .05). The TB group had a greater level of IL-33 (81.05 ± 10.11 pg/mL) than the cytology-positive group (39.37 ± 9.63 pg/mL), while the difference was not statistically significant (P > .05). The level of IL-35 (70.11 ± 10.37 pg/mL) in the TB group was lower than the level of IL-35 (72.13 ± 9.58 pg/mL) in the cytology-positive group. The specificity of the series of combined tests reached 95.81%, which was statistically superior to the single-factor test (P < .05). In the TB group, IFN-γ and IL-33, IFN-γ and IL-35, and IL-33 and IL-35 showed positive correlation. Combined determination of the concentration levels of IL-35, IL-33, and IFN-γ is of value in the diagnosis of tuberculous pleurisy.
本研究探讨白细胞介素-33（IL-33）、干扰素-γ（IFN-γ）和白细胞介素-35（IL-35）联合检测在结核性胸腔积液中的诊断价值。选取2020年12月至2023年12月期间收治的40例病因不明的胸腔积液患者作为研究组。根据相关资料将患者进一步分为结核组（n = 20）和恶性组（n = 20），同时选取20例健康体检者的血清作为对照组。采用胸腔穿刺术采集胸腔积液，采集后运用酶联免疫吸附测定法检测不同类型疾病患者胸腔积液中IL-35、IL-33和IFN-γ的浓度含量。通过SPSS23.0软件进行数据处理与分析，绘制受试者工作特征曲线并比较各指标曲线下面积。结核组患者腺苷脱氨酶水平（59.91 U/L）统计学上高于恶性组（14.31 U/L）（P < 0.05）。两组胸腔积液乳酸脱氢酶水平差异无统计学意义（P > 0.05）。结核组T-SPOT试验阳性率较高（85%），恶性组阳性率较低（45%）。结核组IFN-γ表达水平显著高于恶性组（P < 0.05）。结核组IL-33和IL-35水平高于恶性组，差异有统计学意义（P < 0.05）。结核组IL-33水平（81.05 ± 10.11 pg/mL）高于细胞学阳性组（39.37 ± 9.63 pg/mL），但差异无统计学意义（P > 0.05）。结核组IL-35水平（70.11 ± 10.37 pg/mL）低于细胞学阳性组IL-35水平（72.13 ± 9.58 pg/mL）。系列联合检测的特异性达到95.81%，统计学上优于单因素检测（P < 0.05）。在结核组中，IFN-γ与IL-33、IFN-γ与IL-35、IL-33与IL-35呈正相关。联合检测IL-35、IL-33和IFN-γ的浓度水平对结核性胸膜炎的诊断具有重要价值。
