Abstract

BackgroundTuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE) are very common clinical complications. Considering the totally different prognosis and clinical treatment of TPE and MPE, the accurate and non-invasive diagnosis are very critical for patients with pleural effusion to initiate efficient management and treatment. However, effective clinical biomarkers were rarely explored to distinguish benign from MPE. The purpose of this study is to identify potential miRNAs which can probably be used to differentiate malignant pleural effusion from TPE.ResultsA total of 23 significantly differentially expressed miRNAs were identified in MPE, with 18 up-expressed and 5 down-expressed. And the target genes of the miRNAs mainly involved in the biology process of nervous system, cancer, immune system and metabolic process etc. Three high confident target genes, AGO4, FGF9 and LEF1 can be regulated by miR-195-5p, miR-182-5p and miR-34a-5p respectively. And these genes participate in the canonical pathway of regulation of the Epithelial-Mesenchymal and the biological functions of apoptosis, growth of tumor and cell proliferation of tumor cell lines. Further, RT-PCR validation results based on 64 collected individuals showed that the expression levels of the three miRNAs were 2–5 times higher in MPE samples, which were consistent with the microarray results. In addition, ROC curve analysis demonstrated that the combination of the three miRNAs can achieve higher AUC of 0.93 (p-value< 0.0001) to differentiate MPE from TPE.ConclusionsThe identified miR-195-5p, miR-182-5p and miR-34a-5p can become potential diagnostic biomarkers for MPE with further evidences.

Highlights

  • Tuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE) are very common clinical complications

  • Tuberculosis caused Tuberculosis pleural effusion (TPE) is endemic especially in the developing countries [35], whereas malignant disease like lung cancer is another major factor of pleural effusion, namely malignant pleural effusion (MPE) [17, 25]

  • Identification of differentially expressed miRNAs A total of 23 miRNAs were identified significantly differentially expressed in MPE comparing with TPE after background correction and normalization

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Summary

Introduction

Tuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE) are very common clinical complications. The purpose of this study is to identify potential miRNAs which can probably be used to differentiate malignant pleural effusion from TPE. Various causes can lead to pleural effusion, and one type of effusion caused by tuberculous pleurisy was complicate and time-consuming to differentiate from the other type caused by cancer [20]. The traditional methods to diagnose TPE are based on the microbiological analyses of M.tuberculosis in pleural fluid, sputum and pleural biopsy specimens [25]. Given the low diagnostic yield of pleural fluid cytology and the invasive nature of pleural biopsy, it has limited the clinical application of biochemical tests [2, 22]

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