| Objective:This study selected the basic conditions and pleural effusion of 43 patients with pleural effusion treated in the 940th Hospital of the People's Liberation Army's Joint Service and Support Force(formerly the People's Liberation Army Lanzhou General Hospital)from February2019 to December 2019.The DNA-NETs,inflammation indicators,and immune indicators in the pleural effusion were collated and analyzed,and the general conditions of patients with benign and malignant pleural effusions were comprehensively evaluated.The rank sum test method was used to explore the DNA-NETs effect and value of diagnosis and treatment in benign and malignant pleural effusions of organizing mechanism,in order to provide theoretical basis for the diagnosis and treatment of benign and malignant pleural effusion.Methods:According to the diagnostic criteria of benign and malignant pleural effusion,retrospectively collected 21 cases of benign exudative pleural effusion,12 cases of malignant exudative pleural effusion,and 10 cases of effusion.DAPI was used to stain the three groups of pleural effusion,observed the shape of DNA-NETs in the pleural effusion and calculated the area under a fluorescence microscope,and measured IL-6,C-reactive protein,IgA,IgG,IgM;the pleural fluid viscosity was measured using the"funnel method".After DNase was administered,the pleural effusion viscosity was measured again,and the above indexes were statistically processed.Result:1.Select 43 patients with pleural effusion(26 males and 17females,average age(52.53±16.37 years);21 cases of benign exudative pleural effusions(11 males and 10 females,average age 46.43±11.93 years),12 cases of malignant exudative pleural effusion(9 males and 3 females,average age 67.17±7.48 years;transudate(6 males,4 females,average age47.80±21.65 years).Patients with malignant pleural effusions are olde r In the benign group and the transudate group,the difference was statistically significant(P<0.05);there was no significantdifference in age between the benign group and the transudate group;there was no significant difference in the sex of the three groups of pleural effusion.2.Comparison of the shape and area of pleural effusion NETs in three groups:2.1 From Figure1,Figure 2,and Figure 3,it can be concluded that the NETs in the benign group are more dense and large than those in the malignant group,the transudate group,and the NETs in the malignant group.The structure is more dense and large than exudative group.2.2.Calculate the area of benign and malignant exudative pleural effusion and exudative,respectively.The area of NETs in the benign group is(397.3±57.77)cm~2,the area of NETs in the malignant group is(171±119.6)cm~2,and the area of NETs in the leakage group is(70.20±16.92)cm~2.(See Table 4)After statistical analysis of the three groups of indicators,the benign group had a larger area than the malignant group and the exudative group(P<0.05).The area of the malignant group was not significantly different from the exudative group.3.Inflammatory indexes and immune indexes in pleural effusion:3.1.IL-6 in benign and malignant exudative pleural effusion and exudative were detected.The IL-6 in the pleural effusion of the malignant group was(10830±16585)pg/ml,an d the IL-6 in the pleural effusion of the exudative was(1811±1539)pg/ml.It was concluded that the content of IL-6 in pleural fluid was the highest in the benign group and the middle of the malignant group,with the lowest leakage(P<0.05).It was further proved that the benign group had the strongest inflammatory response in pleural effusion,the malignant group was in the middle,and the leaked group was the weakest.The content of IL-6 in pleural fluid in benign,malignant and effusion groups was higher than that in corresponding serum.It was further confirmed that the local inflammatory response of pleural effusion was stronger than that in serum.3.2.Immune indicators:The levels of IL-6 in pleural fluid and serum were measured in three groups,and the three groups of indicators were compared and analyzed by statistical software.Results(1)The content of CRP in benign group pleural fluid was(4.219±4.947)mg/dl,the malignant group was(1.114±1.24)mg/dl,and the leaked liquid group wa s(0.747±0.51)mg/dl.There was no statistical difference between the two.There was no statistical difference between the CRP in the three groups.(2)The content of IgG in pleural fluid of benign group was(846.1±352.9)mg/dl,that of malignant group was(753.4±179.6)mg/dl,and that of leakage group(271.9±242.6)mg/dl was higher than that of benign group and malignant group.There was no statistical difference between the leakage group and the benign and malignant groups.There was no statistical difference between the IgG in the three groups.(3)The content of IgA in pleural fluid in benign group was(152.6±87.28)mg/dl,malignant group was(112.6±51.57)mg/dl,and leakage fluid group was(36.83±32.19)mg/dl.Both the benign and malignant groups were higher than There was no statistical difference between the leakage group and the benign and malignant groups.There was no statistical difference in IgA between the three groups.(4)The content of IgM in pleural fluid in benign group was(65.65±46.27)mg/dl,malignant group was(77.24±114.7)mg/dl,and leakage fluid group was(14.51±12.59)mg/dl.Both the benign and malignant groups were higher than There was no statistical difference between the leakage group and the benign and malignant groups.There was no statistical difference in IgM between the three groups.4.By calculating the viscosity of the three groups of pleural effusion(dripping speed time),the dripping speed time is used as the ordinate,and the pleural effusion of the three groups is used as the abscissa,and the histogram can be drawn.The longest time was in the benign group,the mediate was in the malignant group and the shortest time was in the exudative group.After DNase treatment,the three groups had a shorter time in the dripping speed time).5.After analyzing the data,we found that the correlation between NETs area in benign group and IL-6 and CRP in pleural effusion[IL-6(r=0.2,p=0.38);CRP(r=0.28,p=0.22)](Figure10,11);the correlation between NETs area in malignant group and IL-6 and CRP in pleural fluid[IL-6(r=0.17,p=0.64);CRP(r=-0.02,p=0.95)](Figures 12 and 13);the correlation between NETs area in exudative group and IL-6 and CRP in pleural effusion[IL-6(r=-0.15,p=0.68);CRP(r=0.35,p=0.32)](Figures 14 and 15);benign and There is a correlation between the NETs area in pleural effusion and IL-6 in benign and malignant pleural effusion.The NETs area in exudative is related to CRP in exudative.The inflammatory response in benign effusion is relatively stronger than that of malignant and exudative pleural effusion.The inflammatory response in pleural effusion may mainly affect the formation and release of NETs,and also participate in organizing mechanism.Conclusions:1.Compared with malignant exudative pleural effusion,benign exudative pleural effusion has a stronger mechanized encapsulation ability,which may be related to the shape and area of DNA-NETs when formed,which can explain benign exudation well.Sexual pleural effusi on is more likely to form orgnized than malignant exudative pleural effusion.2.Compared with malignant exudative pleural effusion,benign exudative pleural effusion ha s a stronger and more severe inflammatory response.The inflammatory response may affect the f ormation and release of DNA-NETs,which will have a certain effect on the ability of organizing of pleural effusion,which will lead to a strong mechanized ability of benign exudative pleural eff usion,which is easy to form organized and malignant pleural effusion pleural effusion is weak in mechanization and is not easy to be orgnized.3.DNase has a certain therapeutic effect on encapsulating pleural effusion.4.For the differential diagnosis of benign and malignant pleural effusions,pleural effusions and effusions,DNA-NETs and inflammation indicators can provide some value for them.It is speculated that DNA-NETs and inflammation indicators can be benign and malignant pleural effusions and pleural effusions.Leakage treatment provides a theoretical basis. |
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