Study On The Relationship Between Osteopontin And Fibrous Tissue Hyperplasia In Tuberculous Pleurisy

ObjectiveTo investigate the relationship between the osteopontin(OPN),transforming growth factor beta(TGF-?),matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-7(MMP-7)and the fibrous tissue hyperplasia of tuberculous pleurisy by detecting the expression of OPN,TGF-?,MMP-9 and MMP-7 in tuberculous pleural effusions.To understand the possible mechanisms.Methods44 patients diagnosed pleural effusion were investigated at the Department of Respiratory medicine in the First Affiliated Hospital of Xi'an Medical University from October 2016 to April 2017.They were divided into three groups,including 23 cases of tuberculous pleurisy,12cases of malignant pleural effusion,and 9 cases of transudate group.All enrolled patients were collected clinical information,and pleural puncture or central venous catheter indwelling was collected within 24 hours of admission to collect pleural effusion.The levels of OPN,TGF-?,MMP-9 andMMP-7weredetectedby enzymelinkedimmunosorbentassay(ELISA).Statistical analysis included t-test,one-way ANOVA,Mann-Whitney test,Kruskal-Wallis test,?2 test and Spearman correlation analysis.The ROC curve was plotted and these four test indicators for predicting pleural fibrous tissue hyperplasiain in tuberculous pleurisy was evaluated according to the area under the curve(AUC).Results1.The proportion of pleural fibrous tissue hyperplasiain in the tuberculosis group was56.52%,which was significantly higher than that in the malignant effusion group and the transudate group.2.The level of OPN in tuberculous group,malignant effusion group and transudate group were58.50(55.87-60.01)?g/L,143.78(118.10-153.15)?g/L,5.84(2.09-11.70)?g/L,withthe highest expression of malignant effusion,the second of the tuberculous group and the lowest transudate group.Tuberculous group compared with the other two groups the difference was significant statistical significance(P<0.001);The level of TGF-?in tuberculosis group,malignanteffusiongroupandtransudategroupwere1805.34(1400.89-1971.34)pg/mL,1711.34(1460.86-1897.93)pg/mL,413.77(384.45-430.25)pg/mL.There was no significant difference between tuberculous group and malignant effusion group(P>0.05),and there was a significant difference between the tuberculosis group and the transudate group(P<0.001).The level of MMP-7 in tuberculosis group,malignant effusion group and transudate group were 60.33(44.76-76.14)?g/L,103.81(87.66-117.95)?g/L,22.94(8.75-25.04)?g/L,with the highest expression of malignant effusion,the second of the tuberculous group and the lowest transudate group.Tuberculous group compared with the other two groups the difference was significant statistical significance(P<0.001);The level of MMP-9 in tuberculosis group,malignant effusion group and transudate group were 91.05(73.04-112.07)?g/L,49.55(19.58-72.61)?g/L,8.38(5.65-11.24)?g/L.The level of the tuberculous group was significantly higher than that of the other two groups,and the difference was statistically significant(P<0.001).3.Correlation analysis between OPN level in tuberculous pleural effusion and clinical data:positive correlation with course of disease,pleural effusion cell number,pleural effusion total protein,pleural effusion ADA content,and erythrocyte sedimentation rate(correlation coefficient:0.496,0.612,0.437,0.436,0.421);Correlation analysis between TGF-?level in tuberculous pleural effusion and clinical data:positive correlation with course of disease,pleural effusion cell number and pleural effusion total protein,(correlation coefficient:0.435,0.429,0.447);Correlation analysis between MMP-7 level in tuberculous pleural effusion and clinical data:positive correlation with course of disease,pleural effusion cell number,pleuraleffusiontotalprotein,pleuraleffusionLDHcontent(correlation coefficient:0.418,0.513,0.528,0.475);Correlation analysis between MMP-9 level in tuberculous pleural effusion and clinical data:positive correlation with course of disease,pleural effusion cell number,pleural effusion total protein,pleural effusion ADA content and pleural effusion LDH content(correlation coefficient:0.421,0.532,0.571,0.428,0.456).4.The clinical data of fibrous tissue hyperplasiain and no case of fibrous tissue hyperplasiain in the tuberculosis group were compared:pleural effusion cell number,pleural effusion total protein,pleural effusion TGF-?,pleural effusion MMP-7,pleural effusion MMP-9and pleural effusion OPN were statistically difference in the two groups.(P<0.05).5.ROC curve analysis:The area under the curve of the pleural effusion OPN as 0.746,the cut-off value as 55.87?g/L,sensitivity as 92.3%,and specificity as 50%;The area under the curve of pleural fluid TGF-?as 0.777,the cut-off value as 1901 pg/mL,sensitivity as 53.8%and specificity as 90%;The area under the curve of MMP-7 in pleural effusion as 0.908,cut-off value as 48.33?g/L,sensitivity as 92.3%,and specificity as 80%;The area under the curve of MMP-9 in pleural fluid as 0.777,cut-off value as 83.43?g/L,sensitivity as 76.9%,specificity as80.0%;The area under the curve of pleural effusion cell number as 0.892,cut-off value as2.7*10~9,sensitivity as 76.92%,specificity as 90%;The area under the curve of pleural effusion total protein as 0.862,cut-off value as 47.2g/L,sensitivity as 92.3%,specificity as 80%.Conclusions1.The levels of TGF-?and MMP-9 are closely related to the inflammatory response in the pleural cavity,and are less affected by the invasion and metastasis of the tumor.The levels of OPN and MMP-7 were greatly influenced by tumor invasion and metastasis.2.The expression of OPN,TGF-?,MMP-7,MMP-9 in pleural effusion are related to the occurrence of pleural fibrous tissue hyperplasia in tuberculous pleurisy.MMP-7 was the most valuable clinical predictor of pleural fibrous hyperplasia in tuberculous pleurisy.