Key result
The proportion of intermediate monocytes in pleural effusion effectively discriminated between tuberculous and malignant pleural effusions with an AUC of 0.906.
Why the study?
Rapid and accurate diagnosis of tuberculous and malignant pleural effusion remains challenging, and little is known about the role of monocyte subpopulations in pleural effusion diagnosis.
Can the proportions of intermediate and nonclassical monocyte subsets in pleural effusion differentiate between tuberculosis and malignancy?
Observational (n=104)
No
Can the proportions of intermediate and nonclassical monocyte subsets in pleural effusion differentiate between tuberculosis and malignancy?
The proportions of intermediate and nonclassical monocytes in pleural fluid, driven by specific chemokine axes, serve as potential novel biomarkers for differentiating tuberculous from malignant pleural effusions.
Answers are grounded in this paper and cite their sources.
May aid differentiation of pleural effusions; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Pleural effusion is a common clinical condition caused by several respiratory diseases, including tuberculosis and malignancy. However, rapid and accurate diagnoses of tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) remain challenging. Although monocytes have been confirmed as an important immune cell in tuberculosis and malignancy, little is known about the role of monocytes subpopulations in the diagnosis of pleural effusion. METHODS: Pleural effusion samples and peripheral blood samples were collected from 40 TPE patients, 40 MPE patients, and 24 transudate pleural effusion patients, respectively. Chemokines (CCL2, CCL7, and CX3CL1) and cytokines (IL-1β, IL-17, IL-27, and IFN-γ) were measured by ELISA. The monocytes phenotypes were analyzed by flow cytometry. The chemokines receptors (CCR2 and CX3CR1) and cytokines above in different monocytes subsets were analyzed by real-time PCR. Receiver operating characteristic curve analysis was performed for displaying differentiating power of intermediate and nonclassical subsets between tuberculous and malignant pleural effusions. RESULTS: intermediate subset proportion in MPE was found elevated. Furthermore, CX3CL1-CX3CR1 axis-mediated infiltration of nonclassical monocytes in TPE was related to CX3CL1 and IFN-γ expression in TPE. Higher expression of cytokines (IL-1β, IL-17, IL-27, and IFN-γ) were found in nonclassical monocytes compared with other subsets. Additionally, the proportions of intermediate and nonclassical monocytes in pleural effusion have the power in discriminating tuberculosis from malignant pleural effusion. CONCLUSIONS: CD14 and CD16 markers on monocytes could be potentially used as novel diagnostic markers for diagnosing TPE and MPE.
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Luo et al. (2022) conducted an observational in Pleural effusion (Tuberculosis vs Malignancy) (n=104). Monocyte subtypes (intermediate and nonclassical) vs. Malignant vs Tuberculous pleural effusion was evaluated on Discriminative ability (AUC) of intermediate monocytes for differentiating TPE from MPE (AUC 0.906). The proportion of intermediate monocytes in pleural effusion effectively discriminated between tuberculous and malignant pleural effusions with an AUC of 0.906.
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