Expression and significance of PD-L1 and CTLA-4 in pleural effusion and peripheral blood mononuclear cells in pa-tients with pleural effusion

XUE Min; YAN Zhijun; GAO Xiwen; ZHUANG Yaqin; PENG Qing; DING Jingyi

doi:10.3969/j.issn.1671-6450.2017.02.012

Abstract：Objective To investigate the expression and clinical significance of anti programmed death ligand 1 ( PD-L1) combined with anti cytotoxic T lymphocyte associated antigen ( CTLA-4) in pleural effusion and peripheral blood mononu-clear cells ( PBMC) in patients with pleural effusion .Methods From June 2015 to June 2016 in Shanghai Minhang Hospital Affiliated Fudan University , 84 patients who were diagnosed and treated of pleural effusion were enrolled as the research ob -ject, including 28 cases of tuberculous pleural effusion and 27 cases of malignant pleural effusion , 29 cases of non tuberculous non malignant pleural effusion .Enzyme linked immunosorbent assay ( ELISA ) and polymerase chain reaction ( PCR ) were used to detect the expression of PD-L1, CTLA-4 in PBMC of pleural effusion , and to analyze the diagnostic value of combined detection of two methods for malignant pleural effusion .Results Compared with non tuberculosis non malignant pleural effu-sion, malignant pleural effusion PBMC’s PD-L1, CTLA-4 mRNA, pleural effusion’s PD-L1 and CTLA-4 expression were sig-nificantly increased , while the above indexes in patients with tuberculous pleural effusion was significantly reduced ( P <0.05);the positive correlation between PD-L1 and CTLA-4 in PBMC and pleural effusion ( r =0.477, r =0.418, P <0.05);PD-L1 and CTLA-4 in pleural effusion ’ s joint detection sensitivity and specificity were respectively 92.5% and 94.7%, which were higher than that of pleural effusion exfoliated cells ’ PD-L1, CTLA-4 separate detection, also its sensitivi-ty and specificity was higher than PBMC .Conclusion The expression of PD-L1, CTLA-4 in pleural effusion, PBMC may be related to the etiology , which can reflect the immune function in the local microenvironment .