The Role Of Intercellular Adhesion Molecule-1 In Tuberculous Pleurisy

Objective: To detect the expression levels of intercellular adhesion molecule-1(ICAM-1)in pleural effusion and serum,and to explore the clinical value of ICAM-1 in tuberculous pleurisy.Methods: A prospective study of 98 patients with pleural effusion were enrolled.Among them,55 patients with tuberculous pleurisy(TPE),20 patients with malignant pleural effusion(MPE),and pneumonia pleural effusion(PPE)were diagnosed by clinical diagnosis or internal thoracoscopic examination.12 cases,11 cases of control group(Controls).Obtain qualified pleural effusions and serum samples and perform routine blood and biochemical analysis of serum samples.The expression levels of ICAM-1 and ADA in pleural effusion and serum were detected in four groups.The pleural effusion samples were counted and counted in white blood cells.The ICAM-1,ADA and white blood cell differential counts of different types of pleural effusion were compared and analyzed.The difference in expression and correlation between pleural fluid and serum,and the value of ICAM-1,ADA and white blood cell differential counts in differential diagnosis of tuberculous pleurisy were analyzed by ROC curve.Results:1.Compared with the control group(673.7±60.8,pg/ml),TPE group(1149.7±48.4,pg/ml),MPE group(1062.5±107.0,pg/ml)and PPE group(1164.4±112.4,pg/ml),The levels of ICAM-1 in the three groups of pleural effusions were significantly increased(p<0.05).The serum levels of ICAM-1(1430.4±46.3,pg/ml)were higher in the TPE group than in the pleural effusions(p<0.001).The difference was statistically significant.2.The percentage of lymphocytes in the pleural effusion of the TPE group(82.7±1.8%)was significantly higher than that of the other three groups,with the MPE group(60.2±5.9%),the PPE group(36.3±7.0%),and the control group(57.4±7.0%).The difference was statistically significant(p<0.05).In the TPE group,the percentage of pleural effusion lymphocytes was significantly higher than serum(16.0±1.0%),and the difference was statistically significant(p<0.0001).3.The ADA level of pleural effusion in TPE group(71.1±4.3,u/l)was significantly higher than that in MPE group(15.4±1.5,u/l)(p<0.001),PPE group(51.9±23.2,u/l)and Control group(14.9 ± 6.7,u/l)(p<0.001).The ADA level of pleural effusion in TPE group was higher than serum(20.0±1.4,u/l),the difference was statistically significant(p<0.0001).4.All subjects had a positive correlation between pleural effusion and total ICAM-1 expression in serum(r=0.3,p<0.05).The overall ICAM-1 in pleural effusion was positively correlated with ADA in all subjects(r=0.4,p< 0.001);the percentage of lymphocytes in pleural effusions was positively correlated with ADA in all subjects(r = 0.3,p< 0.001).5.According to the ROC curve: when ICAM-1>948.7pg/ml in pleural effusion,the specificity of diagnosis of tuberculous pleurisy is the highest,up to 91.0%,but the sensitivity is slightly lower;ADA diagnosis of TB in pleural effusion The specificity and sensitivity of pleurisy are high;the specificity of ICAM-1 and lymphocyte percentage in serum for diagnosis of tuberculous pleurisy is not high.Conclusion: The levels of pleural effusion and serum icam-1 are significantly increased in patients with tuberculous pleurisy.The specificity of icam-1 in pleural effusion for the diagnosis of tuberculous pleurisy is the highest,but the sensitivity is slightly lower.The specificity of icam-1 in the diagnosis of tuberculous pleurisy is not high,and the value of clinical differential diagnosis of tuberculous pleurisy needs further study.