https://scholars.lib.ntu.edu.tw/handle/123456789/190694
標題: | Evaluating pleural ADA, ADA2, IFN-gamma and IGRA for diagnosing tuberculous pleurisy | 作者: | Keng, Li-Ta Shu, Chin-Chung Chen, Jason Yao-Ping Liang, Sheng-Kai Lin, Ching-Kai Chang, Lih-Yu Chang, Chia-Hao Wang, Jann-Yuan Yu, Chong-Jen Lee, Li-Na |
關鍵字: | Adenosine deaminase;Adenosine deaminase 2;Interferon-gamma;Interferon-gamma release assay;Tuberculous pleurisy;T-SPOT.TB assay | 公開日期: | 2013 | 卷: | 67 | 期: | 4 | 起(迄)頁: | 294-302 | 來源出版物: | J. Infect. | 摘要: | Objective: Conventional methods for diagnosing tuberculous pleurisy (TB pleurisy) are either invasive or have a long turn-around-time. Performances of pleural adenosine deaminase (ADA), ADA2, interferon-gamma (IFN-gamma), and interferon-gamma release assays (IGRA) as diagnostic tools for TB pleurisy were evaluated. Methods: Eighty-eight patients with lymphocyte-predominant pleural exudates between June 2010 and March 2011, including 31 with clinically diagnosed TB pleurisy, were prospectively studied. Pleural ADA and ADA2 activity were measured by colorimetric method, IFN-gamma levels by enzyme-linked immuno-sorbent assay, and IGRA by enzyme-linked immuno-spot (T-SPOT.TB) assay. Results: Pleural ADA, ADA2, and IFN-gamma levels, but not the proportion of positive T-SPOT.TB assay, were significantly higher in patients with TB pleurisy than in those without TB pleurisy. The area under the receiver-operating-characteristic (ROC) curve was 0.920, 0.893, 0.875, and 0.544 for IFN-gamma, ADA2, ADA, and T-SPOT.TB assay, respectively. The combination of ADA >= 40 IU/L and IFN-gamma >= 75 pg/mL yielded a specificity of 100%. Conclusions: Pleural ADA, ADA2 and IFN-gamma, but not T-SPOT.TB assay, are all sensitive and specific for TB pleurisy. In patients with lymphocyte-predominant pleural exudates, ADA >= 40 IU/L and IFN-gamma >= 75 pg/mL in pleural effusion imply a very high probability of TB pleurisy. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/259612 |
顯示於: | 醫學系 |
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