Abstract：
OBJECTIVE: Malignant pleural effusion (MPE) is a common complication of lung cancer with poor prognosis. Benign pleural effusion (BPE), such as tuberculous and pneumonic pleural effusion, usually has a good prognosis. Differential diagnosis between MPE and BPE remains a clinical challenge.
METHODS: 52 MPE, 93 BPE, and their corresponding serum samples were analyzed by hydrogen nuclear magnetic resonance (1HNMR) based metabolomics.
RESULTS: The 1HNMR study showed that some amino acids and betaine in MPE are significantly altered in pleural effusion and serum compared to BPE patients. Levels of serum glucose and glutamine have strong positive correlation with those in pleural effusion (r>0.6) for MPE patients. The area under the receiver operating characteristic curve (AUROC) values of metabolites in pleural effusion or serum were less than 0.805 in differentiating MPE from BPE. Improved an AUROC value of 0.901 was observed using pleural effusion-serum ratios of glutamic acid in differentiating MPE from BPE, which was further validated by 15 double-blind samples.
CONCLUSIONS: Compared with BPE patients, amino acids and betaine in MPE are significantly altered in pleural effusion and serum. Pleural effusion-serum ratio of glutamic acid may contribute to the rapid diagnosis of MPE from BPE by 1HNMR analysis.
METHODS: 52 MPE, 93 BPE, and their corresponding serum samples were analyzed by hydrogen nuclear magnetic resonance (1HNMR) based metabolomics.
RESULTS: The 1HNMR study showed that some amino acids and betaine in MPE are significantly altered in pleural effusion and serum compared to BPE patients. Levels of serum glucose and glutamine have strong positive correlation with those in pleural effusion (r>0.6) for MPE patients. The area under the receiver operating characteristic curve (AUROC) values of metabolites in pleural effusion or serum were less than 0.805 in differentiating MPE from BPE. Improved an AUROC value of 0.901 was observed using pleural effusion-serum ratios of glutamic acid in differentiating MPE from BPE, which was further validated by 15 double-blind samples.
CONCLUSIONS: Compared with BPE patients, amino acids and betaine in MPE are significantly altered in pleural effusion and serum. Pleural effusion-serum ratio of glutamic acid may contribute to the rapid diagnosis of MPE from BPE by 1HNMR analysis.
摘要：
目的：恶性胸腔积液（MPE）是肺癌的常见并发症，预后较差。良性胸腔积液(BPE),如结核性和肺炎性胸腔积液，通常预后良好。MPE和BPE之间的鉴别诊断仍然是临床挑战。
方法：52MPE，93BPE,和他们相应的血清样品通过氢核磁共振（1HNMR）为基础的代谢组学分析。
结果：1HNMR研究表明，与BPE患者相比，MPE中的一些氨基酸和甜菜碱在胸腔积液和血清中发生了显着变化。MPE患者的血清葡萄糖和谷氨酰胺水平与胸腔积液（r>0.6）有很强的正相关。在区分MPE和BPE时，胸腔积液或血清中代谢物的受试者工作特征曲线下面积（AUROC）值小于0.805。使用胸腔积液-谷氨酸的血清比率来区分MPE和BPE，观察到AUROC值提高了0.901。15个双盲样本进一步验证。
结论：与BPE患者相比，MPE中的氨基酸和甜菜碱在胸腔积液和血清中明显改变。通过1HNMR分析，胸腔积液与血清谷氨酸的比值可能有助于BPE的MPE的快速诊断。
方法：52MPE，93BPE,和他们相应的血清样品通过氢核磁共振（1HNMR）为基础的代谢组学分析。
结果：1HNMR研究表明，与BPE患者相比，MPE中的一些氨基酸和甜菜碱在胸腔积液和血清中发生了显着变化。MPE患者的血清葡萄糖和谷氨酰胺水平与胸腔积液（r>0.6）有很强的正相关。在区分MPE和BPE时，胸腔积液或血清中代谢物的受试者工作特征曲线下面积（AUROC）值小于0.805。使用胸腔积液-谷氨酸的血清比率来区分MPE和BPE，观察到AUROC值提高了0.901。15个双盲样本进一步验证。
结论：与BPE患者相比，MPE中的氨基酸和甜菜碱在胸腔积液和血清中明显改变。通过1HNMR分析，胸腔积液与血清谷氨酸的比值可能有助于BPE的MPE的快速诊断。
