Abstract:
Objective To explore the potential biomarkers in pleural effusion that are correlated with diagnosis and guide clinical diagnosis and treatment.
Methods Pleural effusion samples were collected from patients treated at The First Affiliated Hospital of Zhengzhou University from April 2020 to May 2021. Tumor-associated macrophages (TAMs) were examined using flow cytometry; lactate and norepinephrine (NE) levels were tested using enzyme-linked immunosorbent assay; and lactate dehydrogenase (LDH) levels were acquired from test results provided by the hospital. The correlations between TAMs; lactate, LDH, and NE levels; clinical diagnosis; and prognosis were analyzed.
Results The NE level in malignant pleural effusion (MPE) samples was significantly higher than that in non-malignant pleural effusion (NMPE) samples (5.24±3.49) ng/mLvs. (2.56±2.25) ng/mL, P<0.05, and positively correlated with malignancy (P<0.05), with an area under the receiver operating characteristic curve (AUC) of 0.751 (P<0.05). NE level and TAMs percentage in MPE were positively associated with poor clinical outcomes (P<0.05), with an AUC of 0.837 and 0.856 for poor prognosis, respectively (P<0.05). The combination of TAMs and lactate and NE levels were more accurate in predicting clinical outcomes, with an AUC of 0.928 (P<0.05).
Conclusions NE is a promising novel diagnostic and prognostic biomarker for malignancy whose ability to predict clinical outcomes is improved when combined with TAMs and lactate levels.