https://scholars.lib.ntu.edu.tw/handle/123456789/508208
標題: | Diagnostic role of inflammatory and anti-inflammatory cytokines and effector molecules of cytotoxic T lymphocytes in tuberculous pleural effusion | 作者: | CHIN-CHUNG SHU JANN-YUAN WANG CHIA-LIN HSU LI-TA KENG Tsui K. Lin J.-F. HSIN-CHIH LAI CHONG-JEN YU LI-NA LEE KWEN-TAY LUH |
公開日期: | 2015 | 卷: | 20 | 期: | 1 | 起(迄)頁: | 147-154 | 來源出版物: | Respirology | 摘要: | Background and objective Early diagnosis of tuberculous pleural effusion (TPE) remains difficult. While some inflammatory markers in pleural effusion (PE) are helpful in diagnosis, the roles of anti-inflammatory cytokines and effector molecules of cytotoxic T lymphocytes have not been investigated. Methods Lymphocyte-predominant exudative PE samples were assayed for inflammatory and anti-inflammatory cytokines and effector molecules of cytotoxic T lymphocytes. Logistic regression analysis was used to predict the probability of TPE and identify independently associated factors. Receiver operating characteristic (ROC) curve analysis was applied to determine the optimal cut-off value for the predicted probability. Results Of 95 patients enrolled, 35 had TPE, 46 had malignant PE and 14 had PE due to other aetiologies. Interferon-γ (IFN-γ), adenosine deaminase (ADA), decoy receptor (DcR) 3, monocyte chemo-attractant protein (MCP)-1, IFN-induced protein (IP)-10, granzyme A and perforin were higher in TPE than in PE of other aetiologies. By logistic regression analysis, IFN-γ?75pg/mL, ADA ? 40 IU/mL, DcR3 ? 9.3 ng/mL and soluble tumour necrosis factor receptor 1 (TNF-sR1) ? 3.2 ng/mL were independent factors associated with TPE. The predicted probability based on the four predictors had an area under the ROC curve of 0.920, with 82.9% sensitivity and 86.7% specificity under the cut-off value of 0.303. In the TPE group, patients with positive PE/pleural culture for Mycobacterium tuberculosis had higher pleural IFN-γ, MCP-1, IP-10 and perforin than those with positive sputum but negative PE culture. Conclusions While pleural interferon-γ and ADA are conventional markers for diagnosing TPE, simultaneous measurements of DcR3 and TNF-sR1 can improve the diagnostic efficacy. Early diagnosis of tuberculous pleural effusion remains difficult. Measuring pleural interferon-γ, adenosine deaminase, decoy receptor 3 and soluble tumour necrosis factor receptor-1 together can improve the low sensitivity of assaying either interferon-γ or adenosine deaminase alone, and may avoid pleural biopsy which is in some patients a high-risk procedure. ? 2014 Asian Pacific Society of Respirology. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/508208 | ISSN: | 1323-7799 | DOI: | 10.1111/resp.12414 | SDG/關鍵字: | adenosine deaminase; antiinflammatory cytokine; cytokine; decoy receptor 3; gamma interferon; gamma interferon inducible protein 10; granzyme A; inflammatory cytokine; monocyte chemotactic protein 1; perforin; unclassified drug; adenosine deaminase; biological marker; decoy receptor 3; gamma interferon; perforin; tumor necrosis factor receptor 1; adult; aged; Article; bacterium culture; cytotoxic T lymphocyte; diagnostic test accuracy study; effector cell; female; human; human cell; lung cancer; lymphocyte; major clinical study; male; Mycobacterium tuberculosis; pleura effusion; prospective study; receiver operating characteristic; sensitivity and specificity; sputum; tuberculosis; tuberculous pleural effusion; blood; complication; cytotoxic T lymphocyte; inflammation; isolation and purification; metabolism; middle aged; Mycobacterium tuberculosis; pathogenicity; pathology; pathophysiology; Pleural Effusion; Tuberculosis, Pleural; Adenosine Deaminase; Aged; Biomarkers; Female; Humans; Inflammation; Interferon-gamma; Male; Middle Aged; Mycobacterium tuberculosis; Perforin; Pleural Effusion; Receptors, Tumor Necrosis Factor, Member 6b; Receptors, Tumor Necrosis Factor, Type I; ROC Curve; Sensitivity and Specificity; T-Lymphocytes, Cytotoxic; Tuberculosis, Pleural |
顯示於: | 醫學檢驗暨生物技術學系 |
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