Differentiating between tuberculous and non-tuberculous pleural effusions using the pleural fluid ratio of 10× adenosine deaminase/lactate dehydrogenase.

Background: Adenosine deaminase (ADA) is a sensitive marker of tuberculous pleural effusion (TBPE). However, in pleural effusion (PE), the detection of ADA alone cannot be used to determine whether the increase in the ADA level is caused by the rising proportion of macrophages and lymphocytes in the cell components or by the increase in the total cell number. The diagnostic precision of ADA is probably restricted due to the false positive and negative results. Thus, we explored the clinical value of the ratio of PE ADA to lactate dehydrogenase (LDH) in differentiating between TBPE and non-TBPE. Methods: Patients hospitalized with PEs between January 2018 and December 2021 were retrospectively recruited for this study. We analyzed the values of ADA, LDH, and 10× ADA/LDH in the patients with TBPE and non-TBPE. We also determined the sensitivity, specificity, Youden index, and area under the curve for 10× ADA/LDH at different ADA levels and evaluated its diagnostic accuracy. Results: In total, 382 patients with PEs were included in the study. Among whom, 144 were diagnosed with TBPE, this supposes a "pre-test probability" >40%. It is quite high, 134 with malignant PEs, 19 with parapneumonic PEs, 43 with empyema, 24 with transudate PEs, and 18 with other types of PE of a known etiology. The ADA levels were positively correlated with the LDH levels in TBPE. LDH levels usually increase in response to cell damage or cell death. The 10× ADA/LDH level was significantly increased in the TBPE patients. In addition, the 10× ADA/LDH level increased as the ADA level increased in TBPE. To differentiate between TBPE and non-TBPE, the optimal cut-off value of 10× ADA/LDH at different ADA levels was assessed using receiver operating curves. At an ADA level >20 U/L, 10× ADA/LDH showed the best diagnostic performance, and had a specificity and sensitivity of 0.94 (95% CI: 0.84-0.98) and 0.95 (95% CI: 0.88-0.98), respectively. Conclusions: The 10× ADA/LDH dependent diagnostic index can be used to distinguish TBPE from non-TBPE and could be used to guide future clinical decisions.

GADD45B predicts lung squamous cell carcinoma survival and impacts immune infiltration, and T cell exhaustion.

BACKGROUND: This study focussed on exploring the prognostic prediction performance of the growth arrest and DNA damage-inducible 45 beta (GADD45B) and its associations with T-cell activity and immune soakage in different malignancies, especially lung squamous cell carcinoma (LUSC). METHODS: We applied TIMER database for comparing the expressions of GADD45B among different cancers. OncoLnc, Gene Expression Profiling Interactive Analysis 2 (GEPIA2), and Kaplan-Meier Plotter were utilised to evaluate the prognostic prediction performance of GADD45B. Besides, the associations of GADD45B with clinical stage, associated gene markers, and immune infiltration were examined through TISIDB, GEPIA2, and Tumour Immune Estimation Resource (TIMER). Biological processes (BPs) and KEGG enrichment analyses were performed to illustrate the possible role of GADD45B in LUSC. The miRWalk database was adopted to analyse the gene miRNA interaction network of GADD45B in LUSC. RESULTS: GADD45B expression was decreased in most of the malignancies, with relation to the poor prognosis in LUSC. GADD45B also significantly affected the survival of LUSC subgroups divided by clinic data. GADD45B significantly correlates with and may stimulate T cell exhaustion in LUSC. CONCLUSIONS: GADD45B is a prognostic indicator in multiple tumours, especially in LUSC. Moreover, modulating GADD45B expression may improve immunotherapy efficacy in LUSC.

CA916798 gene expression is associated with multidrug resistance and predicts progression-free survival in patients with lung cancer.

CA916798 has been identified as a novel multidrug resistance gene in lung cancer cells. However, the expression patterns of CA916798 in tumor tissues prior and subsequent to chemotherapy remain unclear. In the present study, CA916798 expression levels in tumor tissues prior and subsequent to chemotherapy were detected by reverse transcription-quantitative polymerase chain reaction and immunohistochemistry analysis. The prognostic significance of CA916798 expression in tumor tissues was explored by Kaplan-Meier survival analysis and Cox proportional hazards regression analysis. The messenger RNA (mRNA) and protein expression levels of CA916798 in tumor tissues were downregulated post-chemotherapy in chemotherapy-sensitive patients with lung cancer, but not in chemotherapy-resistant patients. Downregulation of CA916798 mRNA and protein expression post-chemotherapy was significantly associated with improved progression-free survival time. The findings from the present study suggest that platinum-based chemotherapy may induce the expression of CA916798, and CA916798 may be a promising biomarker to predict chemotherapy resistance and improve therapies for patients with lung cancer.