Pleural fluid IL-24 as a diagnostic biomarker for differentiating tuberculous from lung adenocarcinoma malignant pleural effusion
ZHOU Huili
QIU Wangli
DUAN Jielin
LIN Keyan
HUANG Qunshan
LAI Tianwen
Abstract：Objective To measure interleukin-24(IL-24)levels in pleural effusions from patients with tuberculosis and lung adenocarcinoma and to evaluate its diagnostic value in differentiating between tuberculous pleural effusion(TPE)and lung adenocarcinoma-associated malignant pleural effusion(LA-MPE).Methods A total of 102 patients with confirmed pleural effusions were enrolled,including 48 TPE and 54 cases of LA-MPE cases.IL-24 concentrations in pleural fluid were measured by enzyme-linked immunosorbent assay(ELISA).Spearman's rank correlation coefficient was used to analyze the correlation between pleural fluid IL-24 levels and clinical parameters.A multivariable diagnostic model was constructed using univariate logistic regression.Results The median concentration of pleural fluid IL-24 in patients with TPE and LA-MPE was 1 031.19 ng/L(464.58 to 2 270.30)and 4 344.68 ng/L(1 733.93 to 10 915.25),respectively,with a significant higher IL-24 levels in LA-MPE compared to TPE(P<0.01).Pleural fluid IL-24 demonstrated utility as a biomarker for distinguishing TPE from LA-MPE,with a cut-off value of 3 316 ng/L,yielding an under the curve(AUC)of 0.835,a specificity of 95.8%,and a sensitivity of 61.1%.Furthermore,guided by univariate logistic regression analysis,we developed a multivariable diagnostic model incorporating CYFRA21-1,CEA,and IL-24.The resulting model,IL-24+CYFRA21-1+CEA,demonstrated the enhanced diagnostic performance.Correlation analysis revealed that in the LA-MPE group,pleural fluid IL-24 positively correlated with pleural fluid adenosine deaminase(ADA)and blood neutrophil count,but negatively correlated with pleural fluid glucose levels.In the TPE group,pleural fluid IL-24 was positively correlated with pleural fluid lactate dehydrogenase(LDH),serum LDH,and blood monocyte count.Conclusion Pleural fluid IL-24 serves as a novel biomarker for differentiating TPE from LA-MPE.The combination of IL-24,CYFRA21-1,and CEA significantly enhances diagnostic accuracy,demonstrating strong potential for clinical differential diagnosis.
Keywords：IL-24tuberculous pleural effusionlung adenocarcinoma-associated malignant pleural effusionELISAbiomarker
Publication Date：2026-02-28
Online Publishing Date：2026-01-28(First online date of this platform, not the publication date of the document)
Pages：8( 9-16 )