scholarly journals Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Thorax ◽  
2017 ◽  
Vol 73 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Wen Wang ◽  
Qiong Zhou ◽  
Kan Zhai ◽  
Yao Wang ◽  
Jing-Yuan Liu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Interferon Gamma ◽  
Predictive Value ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Tuberculous Pleural Effusion ◽  
Interleukin 27 ◽  
Independent Population

BackgroundAccurate differentiating diagnosis is essential for choosing treatment for exudative pleural effusions.ObjectiveTo establish the diagnostic accuracy of interleukin 27 for tuberculous pleural effusion (TPE).MethodsFirst, the concentrations of pleural interleukin 27, interferon-gamma and adenosine deaminase were compared between 51 patients with TPE and 103 with non-TPEs (Beijing cohort), and their diagnostic values were evaluated. These were further verified in another independent population (Wuhan cohort, n=120). In the second part of the study, we performed a meta-analysis.ResultsWith a cut-off value of 591.4 ng/L in the Beijing cohort, the area under the curve, sensitivity, specificity, positive predictive value and negative predictive value of interleukin 27 to diagnose TPE were 0.983 (95% CI 0.947 to 0.997), 96.1% (86.5% to 99.5%), 99.0% (94.7% to 100%), 98.0 (89.4 to 99.9) and 98.1 (93.3 to 99.8), respectively. Excellent diagnostic accuracy of interleukin 27 was also found in the Wuhan cohort and was further confirmed in the meta-analysis. The diagnostic performance of interleukin 27 was comparable to that of interferon-gamma and was more accurate than that of adenosine deaminase. Since the post-test probability of a negative result was always <0.1%, a negative test was considered to exclude TPE in all tuberculosis prevalence settings.ConclusionsInterleukin 27 can be used to diagnose TPE in a high prevalence setting, and a negative result can also be reliably used to rule out TPE in all prevalence settings.

scholarly journals Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A Meta-Analysis

Respiration ◽  
2018 ◽  
Vol 95 (6) ◽  
pp. 469-477 ◽  
Author(s):  
Qing Liu ◽  
Yan-Xia Yu ◽  
Xiao-Juan Wang ◽  
Zheng Wang ◽  
Zhen Wang
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Malignant Pleural Effusion ◽  
Meta Analysis ◽  
Tuberculous Pleural Effusion ◽  
Interleukin 27

scholarly journals Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis

2020 ◽  
Author(s):  
Chun-Guo Jiang ◽  
Wen Wang ◽  
Qiong Zhou ◽  
Xiu-Zhi Wu ◽  
Xiao-Juan Wang ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Older Patients ◽  
Young Patients ◽  
Area Under The Curve ◽  
Tuberculous Pleural Effusion ◽  
Ifn Γ ◽  
Sensitivity Specificity

Abstract Background: Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. We sought to evaluate the influence of age on the diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods: Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing (154 patients) and Wuhan (120 patients) during the same period and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results: Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0%, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3%, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions: Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 is an excellent biomarker to differentiate TPE versus non-TPE cases.

scholarly journals Diagnostic Accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion

2020 ◽  
Vol 24 (4) ◽  
pp. 311-315
Author(s):  
Haroon Ur Rasheed ◽  
Ejaz Hassan Khan ◽  
Mohsin Shafi ◽  
Ahmad Rafiq ◽  
Ambreen Ali ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Colorimetric Method ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Systemic Examination

Objective: To study the diagnostic accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion (TPE).Material and Methods: It was a cross-sectional descriptive study conducted in the Pulmonology departments of Lady Reading and Khyber Teaching Hospital Peshawar and department of Pathology, Khyber Medical College, Peshawar from April 2015 to Jan 2016. A total of 210 tuberculous and non-tuberculous pleural effusion patients were selected through consecutive non-probability sampling techniques. After physical and systemic examination, 3cc of pleural fluid was taken. ADA was estimated by Non-Guisti and Galanti method through the simple colorimetric method. All the data was entered in a specially designed proforma and SPSS v16 was used for statistical analysis.Results: Out of 210 tuberculous and non-tuberculous pleural effusions, the commonest cause of pleural effusion was tuberculosis followed by malignancy. In our study, Pleural fluid ADA levels have sensitivity, specificity, positive predictive value( PPV), and negative predictive value (NPV) of 95.5%, 92.3%, 92.4%, and 96% respectively in differentiating tuberculous pleural effusions from non-tuberculous lymphocytes predominant pleural effusions. Conclusion: Tuberculosis is the commonest infectious disease worldwide. A pleural fluid ADA level of ≥ 35 U/L in lymphocyte-predominant effusions makes mycobacterium tuberculosis most likely etiology. This test is not only very sensitive and specific but also it is very cheap, quick, and easy to perform by routine colorimetric method.  

scholarly journals Unstimulated pleural fluid interferon-gamma for diagnosis of tuberculous pleural effusion: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Sahajal Dhooria ◽  
Kuruswamy Thurai Prasad ◽  
Inderpaul Singh Sehgal ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Interferon Gamma ◽  
Odds Ratio ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Clinical Decision ◽  
Diagnostic Odds Ratio ◽  
Tuberculous Pleural Effusion

Objective: Unstimulated interferon-gamma may be a useful pleural fluid biomarker in the diagnosis of tuberculous pleural effusion (TPE). However, the exact threshold of pleural fluid interferon-gamma and its accuracy during routine clinical decision making is not clear. We assessed the performance of pleural fluid interferon-gamma in diagnosing TPE and tried to identify a useful assay threshold. Methods: We queried the PubMed and Embase databases for publications indexed until May 2020 that provided both sensitivity and specificity data on unstimulated pleural fluid interferon-gamma for diagnosis of TPE. A bivariate random effects model was employed to compute summary estimates for diagnostic accuracy parameters, both overall as well as at threshold ranges of <2, 2-5, and >5 IU/mL. Results: We retrieved 2048 citations, of which 67 publications (7153 patients) were assessed in our review. The summary estimates for sensitivity, specificity, and diagnostic odds ratio were 0.93 (95% CI 0.91-0.95), 0.96 (95% CI 0.94-0.97) and 310.72 (95% CI 185.24-521.18) respectively. Increasing interferon-gamma thresholds did not translate into any substantial change in diagnostic performance; however, eight studies using thresholds >5 IU/mL showed poorer diagnostic accuracy estimates as compared to other studies with lower thresholds. None of the prespecified subgroup variables significantly influenced relative diagnostic odds ratio in a multivariate meta-regression model. All publications demonstrated high risk of bias. Conclusion: Unstimulated pleural fluid interferon-gamma level provides excellent accuracy for diagnosing TPE, and has a potential of becoming a first-line test for this purpose.

scholarly journals Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253525
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Sahajal Dhooria ◽  
Kuruswamy Thurai Prasad ◽  
Inderpaul Singh Sehgal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Interferon Gamma ◽  
Meta Analysis ◽  
Paired Data ◽  
Ifn Γ ◽  
Meta Regression

Objective We compared diagnostic accuracy of pleural fluid adenosine deaminase (ADA) and interferon-gamma (IFN-γ) in diagnosing tuberculous pleural effusion (TPE) through systematic review and comparative meta-analysis. Methods We queried PubMed and Embase databases to identify studies providing paired data for sensitivity and specificity of both pleural fluid ADA and IFN-γ for diagnosing TPE. We used hierarchical summary receiver operating characteristic (HSROC) plots and HSROC meta-regression to model individual and comparative diagnostic performance of the two tests. Results We retrieved 376 citations and included 45 datasets from 44 publications (4974 patients) in our review. Summary estimates for sensitivity and specificity for ADA were 0.88 (95% CI 0.85–0.91) and 0.91 (95% CI 0.89–0.92), while for IFN-γ they were 0.91 (95% CI 0.89–0.94) and 0.96 (95% CI 0.94–0.97), respectively. HSROC plots showed consistently greater diagnostic accuracy for IFN-γ over ADA across the entire range of observations. HSROC meta-regression using test-type as covariate yielded a relative diagnostic odds ratio of 2.22 (95% CI 1.68–2.94) in favour of IFN-γ, along with better summary sensitivity and specificity figures. No prespecified subgroup variable significantly influenced the summary diagnostic accuracy estimates. Conclusion Pleural fluid IFN-γ estimation has better diagnostic accuracy than ADA estimation for diagnosis of TPE.

scholarly journals Complement Component C1q as an Emerging Biomarker for the Diagnosis of Tuberculous Pleural Effusion

2021 ◽  
Vol 12 ◽  
Author(s):  
Xin Qiao ◽  
Ming-Ming Shao ◽  
Feng-Shuang Yi ◽  
Huan-Zhong Shi
Keyword(s):  
Pleural Effusion ◽  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Complement Component ◽  
Enzyme Linked Immunosorbent Assay ◽  
Age And Gender ◽  
Tuberculous Pleural Effusion ◽  
And Gender ◽  
Sensitivity Specificity

Background and Objective: The accurate differential diagnosis of tuberculous pleural effusion (TPE) from other exudative pleural effusions is often challenging. We aimed to validate the accuracy of complement component C1q in pleural fluid (PF) in diagnosing TPE.Methods: The level of C1q protein in the PF from 49 patients with TPE and 61 patients with non-tuberculous pleural effusion (non-TPE) was quantified by enzyme-linked immunosorbent assay, and the diagnostic performance was assessed by receiver operating characteristic (ROC) curves based on the age and gender of the patients.Results: The statistics showed that C1q could accurately diagnose TPE. Regardless of age and gender, with a cutoff of 6,883.9 ng/mL, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of C1q for discriminating TPE were 0.898 (95% confidence interval: 0.825–0.947), 91.8 (80.4–97.7), 80.3 (68.2–89.4), 78.9 (69.2–86.2), and 92.5 (82.6–96.9), respectively. In subgroup analysis, the greatest diagnostic accuracy was achieved in the younger group (≤ 50 years of age) with an AUC of 0.981 (95% confidence interval: 0.899–0.999) at the cutoff of 6,098.0 ng/mL. The sensitivity, specificity, PLR, NLR, PPV, and NPV of C1q were 95.0 (83.1–99.4), 92.3 (64.0–99.8), 97.4 (85.2–99.6), and 85.7 (60.6–95.9), respectively.Conclusion: Complement component C1q protein was validated by this study to be a promising biomarker for diagnosing TPE with high diagnostic accuracy, especially among younger patients.

Diagnostic Accuracy of Tuberculous Pleural Effusion by Combining Adenosine Deaminase Assay and Lymphocyte/ Neutrophil Ratio in Pleural Fluid

2018 ◽  
Vol 7 (7) ◽  
pp. 831-834
Author(s):  
Kande Srinivasulu ◽  
◽  
Aruna Kumari Vadlavalli ◽  
Rajendra Prasad Jalagam ◽  
Nidudhavelu Gopichand ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Tuberculous Pleural Effusion

scholarly journals Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213728 ◽  
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Inderpaul Singh Sehgal ◽  
Sahajal Dhooria
Keyword(s):  
Systematic Review ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Meta Analysis ◽  
Tuberculous Pleural Effusion

Meta-analysis of Indian studies evaluating adenosine deaminase for diagnosing tuberculous pleural effusion

2016 ◽  
Vol 20 (10) ◽  
pp. 1386-1391 ◽  
Author(s):  
A. N. Aggarwal ◽  
R. Agarwal ◽  
I. S. Sehgal ◽  
S. Dhooria ◽  
D. Behera
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Meta Analysis ◽  
Tuberculous Pleural Effusion
Sign in / Sign up

Export Citation Format

Share Document