Monosit Kemoatraktan Protein-1’in Malign Plevral Efüzyon Gelişimindeki Rolü

Abstract

Tekin, F., The Role of Monocyte Chemoattractant Protein-1 in the Development of Malignant Pleural Effusion, Hacettepe University Department of Chest Diseases Specialty Thesis, Ankara, 2021. The mechanism of formation of malignant pleural effusion (MPE), which is one of the most common causes of pleural effusions (PE), is not clearly known and there is no defined treatment method primarily aimed at preventing fluid formation. Current treatment approaches are the drainage of the fluid accumulated in the pleural cavity or the prevention of fluid accumulation by adhering two pleural leaves with pleurodesis. In this study, we aimed to investigate the role of MCP-1, a molecule that is thought to play a role in the development of MPE and which can be targeted for the treatment of MPE. One hundred patients who had PE and underwent diagnostic and/ or therapeutic thoracentesis were included in this prospective study which is conducted between the dates 30.06.2019-30.01.2021. The patients were evaluated in 3 groups as MPE (n = 56), benign exudate (n = 27) and transudate (n = 17) groups. The medaian values of MCP-1 level were determined as 1303 pg/ml in patients in Group 1, 926 pg/ml in Group 2 and 211 pg/ml in Group 3, and the difference between the three groups was statistically significant (p <0.001). MCP-1 levels were found to be significantly higher and similar in the MPE and benign exudate group compared to the transudate group (p=1.0). Pleural fluid MCP-1 and LDH levels were positively correlated both in the whole patient group (r=0.61; p<0.001) and when the MPE and benign exudate groups were considered together (r=0.38; p=0.001). When the patients were grouped as low-moderate and massive according to their amount of pleural fluid, it was observed in the MPE group that MCP-1 levels increase as the amount of pleural fluid increases, although it did not reach a statistical significance. When MPE and benign exudate groups were evaluated together, it was observed that MCP-1 levels significantly increase as the amount of pleural fluid increases (p=0.007). In conclusion; it was observed that MCP-1 levels were high in the MPE group, and this elevation was positively correlated with pleural fluid LDH levels and increased amount of pleural fluid. It was thought that the inflammation accompanying the tumor may have a role in fluid formation and the development of biological therapies which targets MCP-1 may contribute to the management of MPE. Keywords: Pleural effusion, malignant pleural effusion, monocyte chemoattractant protein-1, inflammation, treatment.