Τίτλος:
Interleukin-27 improves the ability of adenosine deaminase to rule out
tuberculous pleural effusion regardless of pleural tuberculosis
prevalence
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Interleukin-27 (IL-27) has been proposed to be useful for
diagnosing tuberculous pleural effusion (TPE). Adenosine deaminase (ADA)
has been long used for the same purpose. The aim of this study was to
compare the performance of IL-27, ADA, and their product (IL-27.ADA) in
the diagnosis of TPE. Methods: Pleural fluid samples from patients with
exudative pleural effusions were assessed for IL-27 and ADA levels.
Receiver operating characteristic (ROC) curves were constructed to
compare the overall diagnostic accuracy of IL-27, ADA, and IL-27.ADA.
Curves of false-positive (FPR) and false-negative (FNR) rates as a
function of TPE prevalence were also constructed, and mean rates of
false results in low (1-10%), intermediate (11-40%), and high
(41-70%) prevalences were estimated to evaluate the ability of the
three markers in ruling in or ruling out TPE. Results: We studied 121
exudates. IL-27 and ADA were higher in TPEs compared with non-TPEs and
they presented similar accuracies for the diagnosis of TPE. The product
of IL-27 and ADA (IL-27.ADA) was more accurate than ADA for the same
purpose. IL-27 and IL-27.ADA presented the lowest overall FPR and FNR,
respectively. The FPR of IL-27, ADA and IL-27.ADA was >9%, even in high
prevalence settings. Although their FNR was <2% in low prevalence
settings, only IL-27.ADA exhibited sufficiently low FNR (<1%) in
intermediate and high prevalences. Conclusions: ADA, IL-27, and
IL-27.ADA cannot reliably ‘rule in’ TPE in any prevalence setting. TPE
can be ‘ruled out’ by each of the biomarkers in low prevalence settings.
In intermediate and high prevalence settings, IL-27.ADA is a reliable
‘rule out’ test in the diagnostic approach to TPEs.
Συγγραφείς:
Skouras, Vasileios S.
Magkouta, Sophia F.
Psallidas, Ioannis and
Tsilioni, Irene
Maragozidis, Panagiotis
Gourgoulianis,
Konstantinos I.
Kalomenidis, Ioannis
Περιοδικό:
INFECTIOUS DISEASES NOW
Εκδότης:
TAYLOR & FRANCIS LTD LONDON
Λέξεις-κλειδιά:
False-negative; false-positive; IL-27; pleural tuberculosis; prevalence
DOI:
10.3109/23744235.2015.1019919
