The Comparison of Pleural Fluid TNF-&amp;#945; and IL-10 Levels with ADA in Tuberculous Pleural Effusion

Çiledağ, Aydın; Kaya, Ayşenur; Erol, Serhat; Şen, Elif; Çelik, Gökhan; Cesur, Salih; Fidan, Yasemin; Kinikli, Sami

doi:10.2174/092986710791233652

Cited by 14 publications

(12 citation statements)

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“…[9,10,19–23] One study was excluded because the same authors published the research on the same patient; thus, only the best quality study was chosen. [24–30] Consequently, the remaining 12 studies were eligible for the meta-analysis, [24–28,31–37] with a total number of 1022 patients. The flowchart of study selection is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Diagnosis of TPE in 7 studies was made based upon histological or bacteriological confirmation, which are considered “gold standard.” [28,31–34,36,37] Whereas in the other remaining 5 studies, TPE patients were diagnosed based upon “gold standard” or on their clinical course which included clinical presentation, pleural fluid analysis, radiology, and the responsiveness to anti-tuberculous therapy. [24–27,35] All the included studies mentioned the TNF-α assay method.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy

Li¹,

Luo²,

Zhu

et al. 2016

Medicine

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Background:The diagnosis of tuberculous pleurisy is difficult and traditional methods are not always helpful. Many studies have focused on the tumor necrosis factor-alpha (TNF-α) assay in pleural effusion for the diagnosis of tuberculous pleurisy, but the results remain controversial. This meta-analysis was conducted to determine the overall diagnostic accuracy of TNF-α.Methods:Relevant studies were searched from PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wangfang, and Weipu. We pooled the published results and computed the accuracy measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Receiver operating characteristic curves (SROC) and the area under the curve (AUC) were used to summarize the overall test performance.Results:Twelve studies with 1022 patients met the inclusion criteria. The pooled sensitivity and specificity were 0.85 (95%CI, 0.81–0.89) and 0.80 (95% CI, 0.77–0.83) respectively. The area under the SROC curve was 0.89.Conclusions:The results of meta-analysis suggested that the TNF-α assay plays a vital role in the diagnosis of tuberculous pleurisy, whereas other test results or clinical findings should be interpreted together with the TNF-α assay to improve the overall diagnostic accuracy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy

Li¹,

Luo²,

Zhu

et al. 2016

Medicine

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“…TNF-α is a small polypeptide with pleiotropic effects on biological and immunological processes. [ 10 ] Its release by mesothelial cells in pleura contributes to the occurrence and development of TP through three mechanisms: It acts as a proinflammatory cytokine to attract neutrophils to kill mycobacteria directly as part of an innate immune response; it acts synergistically with interferon (IFN-γ) to activate macrophages as part of an adaptive immune response; and it recruits naïve T cells to the granuloma. [ 11 ] Tumor necrosis factor-α (TNF-α) levels in the pleural fluid are significantly higher in patients with tuberculosis than in patients with pulmonary malignancy.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of pleural fluid tumor necrosis factor-α in tuberculous pleurisy: A meta-analysis

Qin

et al. 2015

J Res Med Sci

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Background:Pleurisy is a common extra pulmonary complication of tuberculosis, but current methods for diagnosing it are fairly crude. Here we product a meta-analysis for the available evidence on the ability of tumor necrosis factor-α (TNF-α) in pleural fluid to serve as a diagnostic marker of tuberculous pleurisy (TP).Materials and Methods:We searched the PubMed, EMBASE, and Google Scholar databases systematically for studies measuring sensitivity, specificity and other measures of diagnostic accuracy of pleural fluid TNF-α in the diagnosis of TP were meta-analyzed by Stata, version 12 and meta-disc.Results:A total of six publications reporting seven case-control studies were identified. Pooled results indicated that pleural fluid TNF-α showed a diagnostic sensitivity of 0.89 (95% confidence interval [95% CI] 0.83-0.93; range, 0.42-1.0) and a diagnostic specificity of 0.82 (95% CI: 0.78-0.86; range, 0.58-0.98). The pooled positive likelihood ratio was 4.78 (95% CI: 3.32-6.89); the negative likelihood ratio, 0.16 (95% CI: 0.1-0.27); the diagnostic odds ratio, 32.43 (95% CI: 14.48-72.6); and the area under the curve was 0.8556 (standard error of mean 0.0559).Conclusion:Pleural fluid TNF-α levels shows relatively high sensitivity but insufficient specificity for diagnosing TP. Pleural fluid TNF-α measurement may be useful in combination with clinical manifestations and conventional tests such as microbiological examination or pleural biopsy.

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“…The diagnosis of TPE is made by detecting Mycobacterium tuberculosis in the pleural fluids and/or pleural biopsy specimens, or demonstrating caseation granulomas in pleura [6]. However, only 10-35% of biological culture and 20-81% of molecular tests reveal mycobacteria in pleural fluids, and pleural biopsy demonstrates granulomas in 56-82% of samples [7-10]. In addition, the financial problem is a burden for the patients as well.…”

Section: Introductionmentioning

confidence: 99%

“…It is reported that adenosine deaminase (ADA), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interlukine-12 (IL-12), interlukine-18 (IL-18), interlukine-10 (IL-10), interlukine-27 (IL-27), Immunosuppressive acidic protein (IAP), and soluble IL-2 receptor could serve as differential diagnosis biomarkers for pleural effusion caused by TB or malignant diseases [7,11,12]. Adenosine deaminase (ADA), a purine-degrading enzyme implicated in mononuclear phagocyte maturation, has been reported to accumulate in the pleural fluid of TB patients and being predict TB pleurisy with high sensitivity and specificity at 95% and 90% respectively [6].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of tumor necrosis factor-alpha, interferon-gamma, interlukine-10 and adenosine deaminase 2 in differential diagnosis between tuberculous pleural effusion and malignant pleural effusion

Wang

et al. 2014

J Cardiothorac Surg

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BackgroundThe current study was performed to investigate the potential biomarkers for the differential diagnosis of tuberculous pleural effusion (TPE) and malignant pleural effusions (MPE).MethodsAmong ninety patients (n = 90) involved in the study, 47 with tuberculous pleural effusion aged from 18 to 70 and 43 with secondary malignant pleural effusion aged from 34 to 78. We tested the pleural levels of TNF-α, IFN-γ and IL-10 as well as the enzyme activity of ADA2, and then we compared the differential diagnostic efficiencies of those biochemical parameters with ADA between the two groups.ResultsOur results show that, the concentrations of pleural TNF-α (45.55 ± 15.85 ng/L), IFN-γ (114.97 ± 27.85 ng/L) as well as activities of ADA2 (35.71 ± 10.00 U/L) and ADA (39.39 ± 10.60 U/L) in tuberculous group were significantly higher compared to malignant group. Furthermore, according to the ROC curve analysis the thresholds of TNF-α, IFN-γ, ADA2 and ADA were found to be 30.3 ng/L, 103.65 ng/L, 29.45 U/L, and 39.00 U/L, respectively. TNF-α, IFN-γ and ADA2 yielded better sensitivity, specificity, and accuracy of the diagnosis than ADA. Our investigation further revealed that the combinations of TNF-α and ADA2 further increased the specificity and accuracy for the differential diagnosis.ConclusionIn conclusion, we found that TNF-α, IFN-γ, ADA and ADA2 all increased in TPE. Combinations of the TNF-α and ADA2 yielded the best specificity and accuracy for the differential diagnosis of TPE from MPE. Our investigation suggests that the applications of TNF-α together with ADA2 may contribute to more efficient diagnosis strategies in the management of discrimination between tuberculous and malignant pleural effusions.

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The Comparison of Pleural Fluid TNF-α and IL-10 Levels with ADA in Tuberculous Pleural Effusion

Abstract: TNF- alpha is a useful marker in the diagnosis of TPE and IL-10 has no diagnostic value. However, the sensitivity and specificity of TNF-alpha is lower than that of ADA.

Cited by 14 publications

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Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy

Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy

Diagnostic accuracy of pleural fluid tumor necrosis factor-α in tuberculous pleurisy: A meta-analysis

Diagnostic accuracy of tumor necrosis factor-alpha, interferon-gamma, interlukine-10 and adenosine deaminase 2 in differential diagnosis between tuberculous pleural effusion and malignant pleural effusion

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