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Predictive role of adenosine deaminase for differential diagnosis of tuberculosis and malignant pleural effusion in Turkey.
MedLine Citation:
PMID:  21545206     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Tuberculous pleural effusion (TPE) is a common problem for differential diagnosis from malignant effusion (MPE) in epidemic areas of tuberculosis (TB). Prediction based on adenosine deaminase (ADA) is dependent on age as well as the tuberculosis incidence. The aim of the study was to evaluate cutoff values for ADA with sensitivity and specificity results for the differential diagnosis of MPE and TPE in a population with intermediate incidence of TB. We retrospectively analysed 196 patients with a definitive diagnosis of TPE (n=114) and MPE (n= 82). The optimal cutoff value of ADA was determined using the receiver operating characteristic (ROC) curve. There was a statistically significant difference according to the levels of pleural fluid ADA between TPE and MPE groups (p<0.0001). The cutoff value for diagnosing TPE was > 55U/L, with a sensitivity = 86.8%, specificity = 86.6%, positive predictive value (PPV) = 90%, negative predictive value (NPV) = 82.6% and accuracy = 82.6%. We then combined ADA> 55U/L and age< 50 and were able to discriminate the TPE group with increased specifity (95.7 %) and PPV (98.8%) results. The model could correctly classify 21 MPE out of 23 and 82 TPE out of 94 patients. A pleural fluid ADA value < 31U/L suggests that TPE is highly unlikely with a sensitivity = 43.9 %, specificity = 100%, PPV = 100%, NPV = 71.3% and accuracy = 76.6%. It can be concluded that ADA is a very useful parameter for the differential diagnosis of TPE and MPE, specifically in youngers with a higher incidence of tuberculosis.
Authors:
Pinar Birsen Yildiz; Esra Ertan Yazar; Didem Gorgun; Funda Secik; Gulsun Cakir
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian Pacific journal of cancer prevention : APJCP     Volume:  12     ISSN:  1513-7368     ISO Abbreviation:  Asian Pac. J. Cancer Prev.     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130625     Medline TA:  Asian Pac J Cancer Prev     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  419-23     Citation Subset:  IM    
Affiliation:
Pulmonology, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, Turkey E-mail : pinary70@yahoo.com.
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