ABSTRACT
The peptides,proteins and other biological molecules in transudative pleural effusion correlate directly or indirectly with specific physiological and pathological state,reflecting the information regarding the lungs or other parts of the body.In the present study,the peptide fraction in transudative pleural effusion was isolated by uhrafiltration.After desalted and enriched by C18 tips,the peptide mixture was analyzed by nano LC-MS/MS.The results showed that 314 peptides,which were originated from 52 proteins,in pleural transudate were identified.More than half of the peptides were derived from fibrinogen.Many peptides were characterized as displaying ladder sequences.In addition,a large number of proline oxidation modifications were detected in the peptides derived from collagen and fibrinogen.Gene ontology enrichment analysis showed that the most of the proteins extracellular properties of pleural transudate polypeptide components were protein with exocytosis.The study provided a rapid and efficient separation and analysis methods for lung disease markers related peptide compounds in pleural fluid leakage.Also this research provided a rapid and effective method for screening peptide biomarkers related to lung diseases from transudative pleural effusion.
ABSTRACT
BACKGROUND: A few reports of transudative malignant effusion on a small number of patients have suggested the need to perform routine cytologic examination in all cases of transudative pleural effusion, whether encountered for malignancy or not. The purpose of this study was to investigate whether cytologic examination should be performed in all cases of transudative pleural effusion for the diagnosis of malignancy. METHODS: We performed a retrospective study of 229 consecutive patients with malignant pleural effusion, proven either cytologically or with biopsy. In patients with transudative pleural effusion, we reviewed medical records, results of transthoracic echocardiography, fiberoptic bronchoscopy, chest X-ray, chest CT scan, and ultrasonogram of the abdomen. These data were examined with particular attention to identifying whether or not the malignancy was suggested on chest X-ray, examining the involvement of the superior vena cava, great vessels, and lymph nodes, determining the presence of pericardial effusion, and observing the endobronchial obstruction. RESULTS: Transudative malignant pleural effusion was observed in seven (3.1%) of the 229 patients, and was caused either by the malignancy itself (6 patients) or by coexisting cardiac diseases (1 patient). All the patients showed evidence suggesting the presence of malignancy at the time of initial thoracentesis, which facilitated the decision of most clinicians on whether to perform cytologic examination for the diagnosis of malignancy. CONCLUSION: Therefore, in all cases of transudative pleaural effusion, no clinical implications indicating malignancy were found on cytologic examination.