Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis
Abstract Background Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. Combining pleural biomarkers with patients’ age may be a valuable method for diagnosing TPE. We sought to evaluate the influence of age on diagnostic values of pleural adenosine dea...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-020-01219-2 |
| _version_ | 1828395455269044224 |
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| author | Chun-Guo Jiang Wen Wang Qiong Zhou Xiu-Zhi Wu Xiao-Juan Wang Zhen Wang Kan Zhai Huan-Zhong Shi |
| author_facet | Chun-Guo Jiang Wen Wang Qiong Zhou Xiu-Zhi Wu Xiao-Juan Wang Zhen Wang Kan Zhai Huan-Zhong Shi |
| author_sort | Chun-Guo Jiang |
| collection | DOAJ |
| description | Abstract Background Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. Combining pleural biomarkers with patients’ age may be a valuable method for diagnosing TPE. We sought to evaluate the influence of age on diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing and Wuhan between January 1, 2014 and June 30, 2015, and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 and IFN-γ are excellent biomarkers to differentiate TPE versus non-TPE cases. |
| first_indexed | 2024-12-10T08:13:10Z |
| format | Article |
| id | doaj.art-1509817d5511478495d1e7879ddde162 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-10T08:13:10Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-1509817d5511478495d1e7879ddde1622022-12-22T01:56:31ZengBMCBMC Pulmonary Medicine1471-24662020-06-012011910.1186/s12890-020-01219-2Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysisChun-Guo Jiang0Wen Wang1Qiong Zhou2Xiu-Zhi Wu3Xiao-Juan Wang4Zhen Wang5Kan Zhai6Huan-Zhong Shi7Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Background Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. Combining pleural biomarkers with patients’ age may be a valuable method for diagnosing TPE. We sought to evaluate the influence of age on diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing and Wuhan between January 1, 2014 and June 30, 2015, and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 and IFN-γ are excellent biomarkers to differentiate TPE versus non-TPE cases.http://link.springer.com/article/10.1186/s12890-020-01219-2Adenosine deaminaseInterferon-gammaInterleukin 27Tuberculous pleural effusion |
| spellingShingle | Chun-Guo Jiang Wen Wang Qiong Zhou Xiu-Zhi Wu Xiao-Juan Wang Zhen Wang Kan Zhai Huan-Zhong Shi Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis BMC Pulmonary Medicine Adenosine deaminase Interferon-gamma Interleukin 27 Tuberculous pleural effusion |
| title | Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis |
| title_full | Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis |
| title_fullStr | Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis |
| title_full_unstemmed | Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis |
| title_short | Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis |
| title_sort | influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion a post hoc analysis |
| topic | Adenosine deaminase Interferon-gamma Interleukin 27 Tuberculous pleural effusion |
| url | http://link.springer.com/article/10.1186/s12890-020-01219-2 |
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