Background Previous studies reported interleukin-27 （IL-27）, interferon-y （IFN-γ）, or adenosine deaminase （ADA） alone plays a helpful role in diagnosing tuberculous pleural effusion （TPE）. The present study a...Background Previous studies reported interleukin-27 （IL-27）, interferon-y （IFN-γ）, or adenosine deaminase （ADA） alone plays a helpful role in diagnosing tuberculous pleural effusion （TPE）. The present study aims at comparing the diagnostic accuracy of pleural IL-27, IFN-γ, and ADA, and investigate the diagnostic accuracy of the combination of IL-27, IFN-γ, or/ and ADA for differentiating TPE from pleural effusions with the other etiologies. Methods The concentrations of IL-27, IFN-γ and ADA were simultaneously determined in pleural fluids and sera from 40 patients with TPE; 26 with malignant pleural effusion, seven with infectious pleural effusion, and eight with transudative pleural effusion by enzyme linked immunosorbent assay and colorimetric method. The corresponding biochemical indexs were also simultaneously determined. Results The concentrations of pleural IL-27 and IFN-γ in the tuberculous group were significantly higher than those in the malignant, infectious, and transudative groups. The concentrations of ADA in TPE were significantly higher than those in MPE or transudative effusions, while much lower than those in infectious effusions. Among these three biomarkers, IL- 27 was the most effective for TPE diagnosis, with the cut off value of 900.8 ng/L. IL-27 had a high sensitivity of 95% and specificity of 97.6% for differential diagnosis of TPE from non-TPEs. Combinations of IL-27, IFN-γ and ADA measurements further increased the sensitivity or specificity up to 100%. Conclusions Compared to non-TPEs, IL-27, IFN-γ and ADA all simultaneously increased in TPE; and among these three rapid detection methods, IL-27 appeared to be the best for distinguishing tuberculous from non-TPEs, especially from MPE. Combinations of the three markers （IL-27, IFN-γ and ADA） yielded the highest sensitivity and specificity. These findings suggest that the applications of a new biomarker, IL-27, alone or with IFN-γ and ADA, may contribute to more efficient diagnosis strategies in the management 展开更多
The proportion of tuberculous pleurisy among all pleurisy cases is 49.6% andis obviously increasing. However, malignant pleural effusion (29.6% of cases) also accounts for asignificant percentage of pleural diseases. ...The proportion of tuberculous pleurisy among all pleurisy cases is 49.6% andis obviously increasing. However, malignant pleural effusion (29.6% of cases) also accounts for asignificant percentage of pleural diseases. Therefore, tuberculous pleurisy and malignant pleurisyare two main causes for pleural effusion. Because of their quite different prognosis and therapy, itis very important to differentiate them clearly. However, occasionally it is difficult to confirmthe diagnosis. Determination of adenosine deaminase (ADA) in pleural effusion has been confirmed asa useful supplemental diagnostic index for tuberculous pleurisy. However, ADA_2 as a major isoenzymeincreasing in tuberculous pleurisy has not been well investigated in China so far. On the otherhand, interferon- γ (IFN-γ) in tuberculous pleural effusion had been considered as a diagnosticmarker of tuberculous pleurisy. In this study, the concentration of IFN- γ and interlukin-12(IL-12), as well as the activity of ADA and ADA_2 in pleural effusion were measured in order toinvestigate their changes in tuberculous and malignant effusion, and find out the best marker fordiagnosis of tuberculous pleurisy.展开更多
基金This study was supported by grants from the National Natural Science Foundation of China，Natural Science Foundation of Guangxi Zhuang Autonomous Region (No.0728137).The authors have declared that no conflict of interest exists
文摘Background Previous studies reported interleukin-27 （IL-27）, interferon-y （IFN-γ）, or adenosine deaminase （ADA） alone plays a helpful role in diagnosing tuberculous pleural effusion （TPE）. The present study aims at comparing the diagnostic accuracy of pleural IL-27, IFN-γ, and ADA, and investigate the diagnostic accuracy of the combination of IL-27, IFN-γ, or/ and ADA for differentiating TPE from pleural effusions with the other etiologies. Methods The concentrations of IL-27, IFN-γ and ADA were simultaneously determined in pleural fluids and sera from 40 patients with TPE; 26 with malignant pleural effusion, seven with infectious pleural effusion, and eight with transudative pleural effusion by enzyme linked immunosorbent assay and colorimetric method. The corresponding biochemical indexs were also simultaneously determined. Results The concentrations of pleural IL-27 and IFN-γ in the tuberculous group were significantly higher than those in the malignant, infectious, and transudative groups. The concentrations of ADA in TPE were significantly higher than those in MPE or transudative effusions, while much lower than those in infectious effusions. Among these three biomarkers, IL- 27 was the most effective for TPE diagnosis, with the cut off value of 900.8 ng/L. IL-27 had a high sensitivity of 95% and specificity of 97.6% for differential diagnosis of TPE from non-TPEs. Combinations of IL-27, IFN-γ and ADA measurements further increased the sensitivity or specificity up to 100%. Conclusions Compared to non-TPEs, IL-27, IFN-γ and ADA all simultaneously increased in TPE; and among these three rapid detection methods, IL-27 appeared to be the best for distinguishing tuberculous from non-TPEs, especially from MPE. Combinations of the three markers （IL-27, IFN-γ and ADA） yielded the highest sensitivity and specificity. These findings suggest that the applications of a new biomarker, IL-27, alone or with IFN-γ and ADA, may contribute to more efficient diagnosis strategies in the management
文摘The proportion of tuberculous pleurisy among all pleurisy cases is 49.6% andis obviously increasing. However, malignant pleural effusion (29.6% of cases) also accounts for asignificant percentage of pleural diseases. Therefore, tuberculous pleurisy and malignant pleurisyare two main causes for pleural effusion. Because of their quite different prognosis and therapy, itis very important to differentiate them clearly. However, occasionally it is difficult to confirmthe diagnosis. Determination of adenosine deaminase (ADA) in pleural effusion has been confirmed asa useful supplemental diagnostic index for tuberculous pleurisy. However, ADA_2 as a major isoenzymeincreasing in tuberculous pleurisy has not been well investigated in China so far. On the otherhand, interferon- γ (IFN-γ) in tuberculous pleural effusion had been considered as a diagnosticmarker of tuberculous pleurisy. In this study, the concentration of IFN- γ and interlukin-12(IL-12), as well as the activity of ADA and ADA_2 in pleural effusion were measured in order toinvestigate their changes in tuberculous and malignant effusion, and find out the best marker fordiagnosis of tuberculous pleurisy.
