Abstract:
BACKGROUND:The diagnosis of tuberculous pleural effusion (TBPE) has some limitations. We studied the efficacy of interleukin-27 (IL-27) in the diagnosis of TBPE. METHODS:We measured IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ), and the ADA·IL-27 and ADA-2·IL-27 products in all the pleural effusion fluids. The diagnostic yield of IL-27 was evaluated with receiver operating characteristic curves. RESULTS:Of 431 pleural effusions, 70 were tuberculous, 146 were neoplastic, 58 were parapneumonic, 28 were empyemas, 88 were transudates, and 41 were other types. With a cutoff point of 0.55 ng/mL, IL-27 had a sensitivity of 91.4% and a specificity of 85.1%, which were significantly less than ADA, ADA-2, IFNγ, ADA·IL-27, or ADA-2·IL-27. The area under the receiver operating characteristic curve for IL-27 (0.963) was also significantly lower than that for the other markers, except for IFNγ. However, IL-27 improved the sensitivity of ADA and ADA-2 through ADA·IL-27 and ADA-2·IL-27 products (100% for both). CONCLUSIONS:IL-27 is less efficient than ADA and ADA-2 in the diagnosis of TBPE. However, ADA·IL-27 and ADA-2·IL-27 improve the diagnostic sensitivity of ADA and ADA-2, and thus could be useful in situations of high clinical suspicion and low ADA level. A value above the cutoff point of the latter is practically diagnostic of TBPE.
journal_name
Respir Carejournal_title
Respiratory careauthors
Valdés L,San José E,Ferreiro L,Golpe A,Gude F,Álvarez-Dobaño JM,Pereyra MF,Toubes ME,González-Barcala FJdoi
10.4187/respcare.02749subject
Has Abstractpub_date
2014-03-01 00:00:00pages
399-405issue
3eissn
0020-1324issn
1943-3654pii
respcare.02749journal_volume
59pub_type
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