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 language | English |
|---|---|
| Pages (from-to) | 88-94 |
| Number of pages | 7 |
| Journal | Journal of Microbiology, Immunology and Infection |
| Volume | 44 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2011 |
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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 journal › Article
}
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 -