Since February to September 2008, a total of 26 patients with
malignant pleural effusion (MPE) underwent intrapleural
pingyangmycin administration. The concentrations of
PAI-1, t-PA, TGF-beta(1) and the number of leucocytes in peripheral blood and
pleural effusion before and
after treatment were detected. The
pleurodesis efficacy according to WHO standard was evaluated 1 month later. Patients who showed complete disappearance of
pleural effusion lasting more than 1 month and reduction of
pleural effusion more than 50% were classified as the effective group, while the others were classified as the failure group.
RESULTS: One month after intrapleural
pingyangmycin administration, the total response rate of MPE control was 57.7% (effective group = 15 cases). The number of leucocytes and neutrophils in peripheral blood were significantly higher after intrapleural
pingyangmycin administration [the number of leucocytes: effective group (9.2 +/- 2.0) x 10(9)/L, failure group (9.4 +/- 3.8) x 10(9)/L; neutrophil count: effective group (7.9 +/- 2.1) x 10(9)/L, failure group (8.1 +/- 3.3) x 10(9)/L] than in those before[the number of leucocytes: effective group (6.6 +/- 1.4) x 10(9)/L, failure group (5.6 +/- 0.9) x 10(9)/L; neutrophil count: effective group (4.5 +/- 1.3) x 10(9)/L, failure group (4.2 +/- 1.0) x 10(9)/L. F = 30.80, 46.08 respectively, all P < 0.01]. However, the concentrations of
PAI-1, t-PA and TGF-beta(1) in the peripheral blood showed no significant difference before and
after treatment(P > 0.05). The concentrations of
PAI-1 were significantly lower in the
pleural effusion before treatment [effective group (1054 +/- 1039) microg/L, failure group (1027 +/- 955) microg/L] than
after treatment [24 h after intrapleural
pingyangmycin administration: effective group (2195 +/- 861) microg/L, failure group (1099 +/- 568) microg/L]; 72 h
after treatment: effective group (1688 +/- 703) microg/L, failure group (1383 +/- 797) microg/L(F = 6.29, P = 0.01). The levels of t-PA were significantly higher in the
pleural effusion before treatment [the effective group (42 +/- 33) microg/L, failure group (54 +/- 25) microg/L] than
after treatment[24 h after intrapleural
pingyangmycin administration: the effective group (49 +/- 49) microg/L, failure group (53 +/- 40) microg/L; 72 h
after treatment: the effective group (17 +/- 20) microg/L, failure group (28 +/- 22) microg/L (F = 19.85, P < 0.01). The levels of TGF-beta(1) in the
pleural effusion showed no significant difference before and
after treatment (P > 0.05). The number of leucocytes in
pleural effusion was significantly higher after intrapleural
pingyangmycin administration [the effective group (4.7 +/- 4.7) x 10(9)/L, failure group (2.1 +/- 1.4) x 10(9)/L] than before [the effective group (2.3 +/- 1.9) x 10(9)/L, failure group (1.0 +/- 0.9) x 10(9)/L. F = 8.05, P < 0.01]. The number of leucocytes, neutrophils and the concentrations of
PAI-1, t-PA, TGF-beta(1) in the peripheral blood showed no significant difference between the effective group and the failure group before and
after treatment (P > 0.05). However, the concentrations of
PAI-1 in
pleural effusion after treatment were higher in the effective group than in the failure group (F = 8.51, P < 0.01).
CONCLUSION: