The Value Of MerTK In Differential Diagnosis Of Tuberculous And Malignant Pleural Effusion

Objective:By detecting the concentration MerTK in pleural fluid supernatant of patients with pleural effusion and analyzing the correlation between inflammatory markers and MerTK of patients with pleural effusion,to evaluate the diagnostic value of MerTK in the differential diagnosis of pleural effusion and it correlation with inflammatory reaction.Object of study and Methods:From April 2017 to September 2018,we screened eligible patients with primary pleural effusion admitted to the first hospital of jilin university,and collected their initial pleural puncture fluid.The supernatant of pleural effusion should be obtained by laboratory treatment within 30 minutes.A total of 104 patients were brought into this study after performing thoracoscopic surgery,they are all diagnosised clarifily by pathology.There were 54 cases in the group of tuberculous pleural effusion and 50 cases of malignant pleural effusion.General data of patients were collected and the concentration of MerTK in tuberculous pleural effusion group and malignant pleural effusion group was detected by ELISA.The SPSS17 software was used for statistical analysis.1)If the data between the two groups conform to the normal distribution,the mean ±standard deviation(x±s)was used to represent,and the median(quartile)was used to represent the non-normal distribution.The comparison among the data sets indicated that the t-test was selected for normal distribution,while the nonparametric rank sum test was selected for non-normal distribution.2)To study the diagnostic value of the expression level of MerTK in pleural effusion for hydrothorax,the subject operating characteristic curve(ROC)was used for analysis.3)To study the correlation between the expression level of MerTK in pleural effusion and the expression levels of various inflammatory factors in pleural effusion,such as IL-1β and TNF-α,Pearson linear correlation method was used to analyze the correlation coefficient,which was expressed by R and the difference was statistically significant with P < 0.05.Result:The concentration of MerTK in tuberculous pleural effusion was5310.38±2769.791ng/L,and that in malignant pleural effusion was904.29±561.547ng/L.The concentration of MerTK in tuberculous pleural effusion was significantly higher than that in malignant pleural effusion(P<0.0001).The AUC of MerTK was 0.961,the sensitivity was 88.9%,and the specificity was 98.0%,the best cut-off value was 2178.22ng/L in identifying TPE and MPE(P<0.01).There was no correlation between MerTK and IL-1β,TNF-α in the TPE and MPE group(P>0.05).Conclusion:1.There was a statistically significant difference in the expression level of MerTK between the two groups of tuberculous pleural effusion and malignant pleural effusion(P<0.0001).2.When the concentration of MerTK in the supernatant of pleural effusion is greater than 2178.22ng/L,it tends to be tuberculous pleural effusion.3.When the concentration of MerTK in the supernatant of pleural effusion is less than 2178.22ng/L,malignant pleural effusion tends to occur.