Interleukin 27 could be useful in the diagnosis of tuberculous pleural effusions

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 (IFNgamma), and the ADA.IL-27 and ADA-2.IL-27 products in...

ver descrição completa

Detalhes bibliográficos
Autores: Valdés Cuadrado, Luis, José, E. S., Ferreiro Fernández, Lucía, Golpe Gómez, Antonio, Gude Sampedro, Francisco, Alvarez Dobaño, Jose Manuel, Pereyra Barrionuevo, Marco Francisco, Toubes Navarro, Maria Elena, González Barcala, Francisco Javier
Formato: artículo
Fecha de publicación:2014
País:España
Recursos:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/6322
Acesso em linha:http://hdl.handle.net/20.500.11940/6322
Access Level:acceso abierto
Palavra-chave:Adenosine Deaminase
Adolescent
Adult
Aged
Aged, 80 and over
Extravascular Lung Water
Female
Humans
Interferon-gamma
Interleukin-27
Male
Middle Aged
Pleural Effusion
Prospective Studies
ROC Curve
Sensitivity and Specificity
Tuberculosis, Pleural
Young Adult
Descrição
Resumo: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 (IFNgamma), 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, IFNgamma, 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 IFNgamma. 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.