IL-33和sST2在恶性胸腔积液和结核性胸腔积液患者胸腔积液和外周血中的表达水平及其临床意义

发布时间：2018-08-31 13:29

【摘要】：目的:探讨恶性胸腔积液(MPE)和结核性胸腔积液(TPE)患者胸腔积液及相应外周血中白细胞介素33(IL-33)和可溶性ST2(sST2)表达水平,阐明其临床意义。方法:选择72例胸腔积液患者(其中MPE 42例,TPE 30例),采用酶联免疫吸附测定(ELISA)法检测胸腔积液和外周血IL-33和sST2表达水平,另选本院体检正常者38人为健康对照组。比较MPE、TPE患者和健康对照组受试者胸腔积液和血清中IL-33及sST2表达水平,分析2组患者胸腔积液和血清中IL-33和sST2表达水平的相关性。采用受试者工作特征曲线(ROC曲线)确定IL-33表达水平和sST2/IL-33比值鉴别MPE和TPE的阈值及其特异度和敏感度。结果:MPE和TPE患者血清中IL-33和sST2表达水平比较差异无统计学意义(P0.05),但均明显高于健康对照组(P0.01)。TPE患者胸腔积液中IL-33表达水平明显高于其相应血清水平(P0.01),MPE患者胸腔积液中IL-33表达水平明显低于其相应血清水平(P0.05),TPE患者胸腔积液中IL-33表达水平明显高于MPE患者(P0.05)。MPE患者胸腔积液中sST2表达水平明显高于TPE患者(P0.01)。MPE和TPE患者胸腔积液中IL-33水平与其相应血清中IL-33水平均呈正相关关系(rMPE=0.930 4,rTPE=0.990 7,P0.05);MPE患者胸腔积液中sST2水平与其相应血清中sST2水平呈正相关关系(r=0.934 5,P0.05),但TPE患者胸腔积液中sST2水平与其相应血清中sST2水平无相关性。ROC曲线结果,鉴别TPE和MPE的胸腔积液中IL-33表达水平的最佳阈值为17.08ng·L~(-1),相应敏感度和特异度分别为96.7%和92.9%;胸腔积液中sST2/IL-33比值鉴别TPE和MPE的最佳阈值为15.06,相应敏感度和特异度分别为96.8%和95.5%。结论:IL-33和sST2不同程度地参与了TPE和MPE的胸膜炎症反应。监测胸腔积液中IL-33表达水平和sST2/IL-33比值可能是鉴别良、恶性胸腔积液的新方法,有较高的临床应用价值。
[Abstract]:Objective: to investigate the expression levels of interleukin-33 (IL-33) and soluble ST2 (sST2) in pleural effusion (MPE) and tuberculous pleural effusion (TPE) in patients with malignant pleural effusion and tuberculous pleural effusion, and to elucidate its clinical significance. Methods: the expression of IL-33 and sST2 in pleural effusion and peripheral blood of 72 patients with pleural effusion (including 42 patients with MPE and 30 patients with MPE) were detected by (ELISA) assay. 38 normal subjects were selected as healthy control group. To compare the expression levels of IL-33 and sST2 in pleural effusion and serum of MPE,TPE patients and healthy control subjects, and to analyze the correlation between the expression levels of IL-33 and sST2 in pleural effusion and serum of the two groups. The threshold, specificity and sensitivity of MPE and TPE were identified by using the ROC curve to determine the expression level of IL-33 and the ratio of sST2/IL-33. Results there was no significant difference in the expression of IL-33 and sST2 between the two groups (P0.05), but they were significantly higher than those in the control group (P0.01). The expression of IL-33 in the pleural effusion of the patients with TPE was significantly higher than that in the patients with MPE (P0.01). The expression of IL-33 in pleural effusion in patients with IL-33 was significantly lower than that in patients with MPE (P0.05). The expression of sST2 in pleural effusion in patients with MPE was significantly higher than that in patients with TPE (P0.01). MPE and IL-33 in pleural effusion of TPE patients. There was a positive correlation between sST2 level in pleural effusion and sST2 level in corresponding serum (P 0.05), but sST2 level in pleural effusion of TPE patients and sST2 level in corresponding serum were positively correlated (P 0.05). No correlation. ROC curve results, The optimal threshold of IL-33 expression in pleural effusion of TPE and MPE was 17.08ng L-1, and the corresponding sensitivity and specificity were 96.7% and 92.9%, respectively, and the optimum threshold of sST2/IL-33 ratio in pleural effusion was 15.06, and the corresponding sensitivity and specificity were 96.8% and 95.5%, respectively. Conclusion: 1-IL-33 and sST2 are involved in pleural inflammation of TPE and MPE to varying degrees. Monitoring the expression level of IL-33 and the ratio of sST2/IL-33 in pleural effusion may be a new method for differentiating benign and malignant pleural effusion.
【作者单位】：吉林大学第一医院呼吸内科;
【基金】：吉林省发改委科研基金资助课题(JF2016C0061)
【分类号】：R521.7;R730.43

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