Differential diagnosis of tuberculous and malignant pleurisy using pleural fluid adenosine deaminase and interferon gamma in Taiwan

Yung Ching Liu, Susan Shin-Jung Lee, Yao Shen Chen, Hui Zin Tu, Bao Chen Chen, Tsi Shu Huang

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Accurately differentiating tuberculous pleurisy from lung cancer is important for disease management but difficult using conventional laboratory methods. This study assessed the value of adenosine deaminase (ADA) and interferon gamma (IFN-γ) for differentiating the two conditions in a region of Taiwan with a high prevalence of tuberculosis. The study population comprised patients with lymphocytic exudative pleural effusions: tuberculous (n= 24) and malignant (n= 42). Mean levels of ADA and IFN-γ in pleural fluid, measured with commercial standardized kits, were significantly higher for tuberculous than for malignant pleurisy (p<0.001 for both). For differentiating the two effusions, results for ADA versus IFN-γ were: sensitivity, 70.8% versus 91.7%; specificity, 95.2% versus 97.6%; positive predictive value, 89.5% versus 96.7%; and negative predictive value, 85.1% versus 95.3%. IFN-γ allows precise diagnosis of pleural tuberculosis, but ADA is easier to use, has a low cost, and results are quickly available. Our study confirms previous studies and extends the usefulness of these diagnostic methods to a wider group of clinical laboratories by showing the reliability of standardized relatively inexpensive commercial kits. We recommend that initial ADA screening be used in conjunction with IFN-γ measurements for differential diagnosis of tuberculous pleurisy.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume44
Issue number2
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Pleural Tuberculosis
Adenosine Deaminase
Taiwan
Interferon-gamma
Differential Diagnosis
Pleural Effusion
Disease Management
Lung Neoplasms
Tuberculosis
Costs and Cost Analysis
Population

Keywords

  • Adenosine deaminase
  • Interferon gamma
  • Malignant pleurisy
  • Pleural effusion
  • Tuberculous pleurisy

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Infectious Diseases

Cite this

Differential diagnosis of tuberculous and malignant pleurisy using pleural fluid adenosine deaminase and interferon gamma in Taiwan. / Liu, Yung Ching; Shin-Jung Lee, Susan; Chen, Yao Shen; Tu, Hui Zin; Chen, Bao Chen; Huang, Tsi Shu.

In: Journal of Microbiology, Immunology and Infection, Vol. 44, No. 2, 04.2011, p. 88-94.

Research output: Contribution to journalArticle

Liu, Yung Ching ; Shin-Jung Lee, Susan ; Chen, Yao Shen ; Tu, Hui Zin ; Chen, Bao Chen ; Huang, Tsi Shu. / Differential diagnosis of tuberculous and malignant pleurisy using pleural fluid adenosine deaminase and interferon gamma in Taiwan. In: Journal of Microbiology, Immunology and Infection. 2011 ; Vol. 44, No. 2. pp. 88-94.
@article{04cd37d55f634ef0884d684dba0ef813,
title = "Differential diagnosis of tuberculous and malignant pleurisy using pleural fluid adenosine deaminase and interferon gamma in Taiwan",
abstract = "Accurately differentiating tuberculous pleurisy from lung cancer is important for disease management but difficult using conventional laboratory methods. This study assessed the value of adenosine deaminase (ADA) and interferon gamma (IFN-γ) for differentiating the two conditions in a region of Taiwan with a high prevalence of tuberculosis. The study population comprised patients with lymphocytic exudative pleural effusions: tuberculous (n= 24) and malignant (n= 42). Mean levels of ADA and IFN-γ in pleural fluid, measured with commercial standardized kits, were significantly higher for tuberculous than for malignant pleurisy (p<0.001 for both). For differentiating the two effusions, results for ADA versus IFN-γ were: sensitivity, 70.8{\%} versus 91.7{\%}; specificity, 95.2{\%} versus 97.6{\%}; positive predictive value, 89.5{\%} versus 96.7{\%}; and negative predictive value, 85.1{\%} versus 95.3{\%}. IFN-γ allows precise diagnosis of pleural tuberculosis, but ADA is easier to use, has a low cost, and results are quickly available. Our study confirms previous studies and extends the usefulness of these diagnostic methods to a wider group of clinical laboratories by showing the reliability of standardized relatively inexpensive commercial kits. We recommend that initial ADA screening be used in conjunction with IFN-γ measurements for differential diagnosis of tuberculous pleurisy.",
keywords = "Adenosine deaminase, Interferon gamma, Malignant pleurisy, Pleural effusion, Tuberculous pleurisy",
author = "Liu, {Yung Ching} and {Shin-Jung Lee}, Susan and Chen, {Yao Shen} and Tu, {Hui Zin} and Chen, {Bao Chen} and Huang, {Tsi Shu}",
year = "2011",
month = "4",
doi = "10.1016/j.jmii.2010.04.001",
language = "English",
volume = "44",
pages = "88--94",
journal = "Journal of Microbiology, Immunology and Infection",
issn = "0253-2662",
publisher = "Elsevier Taiwan LLC",
number = "2",

}

TY - JOUR

T1 - Differential diagnosis of tuberculous and malignant pleurisy using pleural fluid adenosine deaminase and interferon gamma in Taiwan

AU - Liu, Yung Ching

AU - Shin-Jung Lee, Susan

AU - Chen, Yao Shen

AU - Tu, Hui Zin

AU - Chen, Bao Chen

AU - Huang, Tsi Shu

PY - 2011/4

Y1 - 2011/4

N2 - Accurately differentiating tuberculous pleurisy from lung cancer is important for disease management but difficult using conventional laboratory methods. This study assessed the value of adenosine deaminase (ADA) and interferon gamma (IFN-γ) for differentiating the two conditions in a region of Taiwan with a high prevalence of tuberculosis. The study population comprised patients with lymphocytic exudative pleural effusions: tuberculous (n= 24) and malignant (n= 42). Mean levels of ADA and IFN-γ in pleural fluid, measured with commercial standardized kits, were significantly higher for tuberculous than for malignant pleurisy (p<0.001 for both). For differentiating the two effusions, results for ADA versus IFN-γ were: sensitivity, 70.8% versus 91.7%; specificity, 95.2% versus 97.6%; positive predictive value, 89.5% versus 96.7%; and negative predictive value, 85.1% versus 95.3%. IFN-γ allows precise diagnosis of pleural tuberculosis, but ADA is easier to use, has a low cost, and results are quickly available. Our study confirms previous studies and extends the usefulness of these diagnostic methods to a wider group of clinical laboratories by showing the reliability of standardized relatively inexpensive commercial kits. We recommend that initial ADA screening be used in conjunction with IFN-γ measurements for differential diagnosis of tuberculous pleurisy.

AB - Accurately differentiating tuberculous pleurisy from lung cancer is important for disease management but difficult using conventional laboratory methods. This study assessed the value of adenosine deaminase (ADA) and interferon gamma (IFN-γ) for differentiating the two conditions in a region of Taiwan with a high prevalence of tuberculosis. The study population comprised patients with lymphocytic exudative pleural effusions: tuberculous (n= 24) and malignant (n= 42). Mean levels of ADA and IFN-γ in pleural fluid, measured with commercial standardized kits, were significantly higher for tuberculous than for malignant pleurisy (p<0.001 for both). For differentiating the two effusions, results for ADA versus IFN-γ were: sensitivity, 70.8% versus 91.7%; specificity, 95.2% versus 97.6%; positive predictive value, 89.5% versus 96.7%; and negative predictive value, 85.1% versus 95.3%. IFN-γ allows precise diagnosis of pleural tuberculosis, but ADA is easier to use, has a low cost, and results are quickly available. Our study confirms previous studies and extends the usefulness of these diagnostic methods to a wider group of clinical laboratories by showing the reliability of standardized relatively inexpensive commercial kits. We recommend that initial ADA screening be used in conjunction with IFN-γ measurements for differential diagnosis of tuberculous pleurisy.

KW - Adenosine deaminase

KW - Interferon gamma

KW - Malignant pleurisy

KW - Pleural effusion

KW - Tuberculous pleurisy

UR - http://www.scopus.com/inward/record.url?scp=79952898173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952898173&partnerID=8YFLogxK

U2 - 10.1016/j.jmii.2010.04.001

DO - 10.1016/j.jmii.2010.04.001

M3 - Article

VL - 44

SP - 88

EP - 94

JO - Journal of Microbiology, Immunology and Infection

JF - Journal of Microbiology, Immunology and Infection

SN - 0253-2662

IS - 2

ER -