Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion
Abstract Background Tuberculosis (TB) remains a major public health concern on a global scale, especially in developing nations. So far, no formal guidelines are available for the diagnosis and treatment of tuberculosis pleurisy. The diagnosis of TB is worsened by the immense difficulty in different...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-018-3654-z |
| _version_ | 1818301663959580672 |
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| author | Yimin Tang Juanjuan Zhang Huarong Huang Xing He Jiaohong Zhang Min Ou Guobao Li Changchun Zeng Taosheng Ye Lili Ren Yingxia Liu Guoliang Zhang |
| author_facet | Yimin Tang Juanjuan Zhang Huarong Huang Xing He Jiaohong Zhang Min Ou Guobao Li Changchun Zeng Taosheng Ye Lili Ren Yingxia Liu Guoliang Zhang |
| author_sort | Yimin Tang |
| collection | DOAJ |
| description | Abstract Background Tuberculosis (TB) remains a major public health concern on a global scale, especially in developing nations. So far, no formal guidelines are available for the diagnosis and treatment of tuberculosis pleurisy. The diagnosis of TB is worsened by the immense difficulty in differential determination of tuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE). The purpose of this investigation is to assess the differential diagnostic efficiencies of the pleural IFN-γ release assay (IGRA) and widely-used biochemical parameters in the distinction analysis of TPE and MPE. Methods A cohort of 222 patients with pleural effusion was examined, comprising of 143 TPE and 58 MPE patients. The patients were examined with IGRA, and the widely-used biomarkers in the pleural effusion and peripheral blood. Results Our results show that the TPE patients have significantly higher M. tuberculosis (Mtb) antigen-specific IFN-γ responses to ESAT-6 protein and peptide pool in the blood compared to MPE patients. TPE patients were also shown to have enriched Mtb antigen-specific IFN-γ responses in pleural effusion than in peripheral blood. Among the widely-used biomarkers, the adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) in pleural effusion were better biomarkers with high sensitivity and specificity to discriminate TPE and MPE. In addition, pleural IGRA could not be affected by the pleural adhesion, and the applications of the pleural IGRA together with ADA and CEA provide a promising approach for the TPE and MPE differential identification. Conclusions Our study proposes that the integration of pleural IGRA and ADA, CEA detection could add to more effective diagnosis stratagems in the discernment between TPE and MPE. |
| first_indexed | 2024-12-13T05:26:36Z |
| format | Article |
| id | doaj.art-44885a0d04d9433b9aa197ede07898f8 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T05:26:36Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-44885a0d04d9433b9aa197ede07898f82022-12-21T23:58:10ZengBMCBMC Infectious Diseases1471-23342019-01-011911810.1186/s12879-018-3654-zPleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusionYimin Tang0Juanjuan Zhang1Huarong Huang2Xing He3Jiaohong Zhang4Min Ou5Guobao Li6Changchun Zeng7Taosheng Ye8Lili Ren9Yingxia Liu10Guoliang Zhang11Department of Tuberculosis, Shenzhen Third People’s Hospital, University of South ChinaDepartment of Laboratory Medicine, Shenzhen Longhua District Central Hospital, Guangdong Medical UniversityGuangdong Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, University of South ChinaGuangdong Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, University of South ChinaDepartment of Tuberculosis, Shenzhen Third People’s Hospital, University of South ChinaDepartment of Tuberculosis, Shenzhen Third People’s Hospital, University of South ChinaDepartment of Tuberculosis, Shenzhen Third People’s Hospital, University of South ChinaDepartment of Laboratory Medicine, Shenzhen Longhua District Central Hospital, Guangdong Medical UniversityDepartment of Tuberculosis, Shenzhen Third People’s Hospital, University of South ChinaMOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences & Peking Union Medical CollegeGuangdong Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, University of South ChinaGuangdong Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, University of South ChinaAbstract Background Tuberculosis (TB) remains a major public health concern on a global scale, especially in developing nations. So far, no formal guidelines are available for the diagnosis and treatment of tuberculosis pleurisy. The diagnosis of TB is worsened by the immense difficulty in differential determination of tuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE). The purpose of this investigation is to assess the differential diagnostic efficiencies of the pleural IFN-γ release assay (IGRA) and widely-used biochemical parameters in the distinction analysis of TPE and MPE. Methods A cohort of 222 patients with pleural effusion was examined, comprising of 143 TPE and 58 MPE patients. The patients were examined with IGRA, and the widely-used biomarkers in the pleural effusion and peripheral blood. Results Our results show that the TPE patients have significantly higher M. tuberculosis (Mtb) antigen-specific IFN-γ responses to ESAT-6 protein and peptide pool in the blood compared to MPE patients. TPE patients were also shown to have enriched Mtb antigen-specific IFN-γ responses in pleural effusion than in peripheral blood. Among the widely-used biomarkers, the adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) in pleural effusion were better biomarkers with high sensitivity and specificity to discriminate TPE and MPE. In addition, pleural IGRA could not be affected by the pleural adhesion, and the applications of the pleural IGRA together with ADA and CEA provide a promising approach for the TPE and MPE differential identification. Conclusions Our study proposes that the integration of pleural IGRA and ADA, CEA detection could add to more effective diagnosis stratagems in the discernment between TPE and MPE.http://link.springer.com/article/10.1186/s12879-018-3654-zTuberculosis pleural effusionMalignant pleural effusionIFN-γ release assayAdenosine deaminaseCarcinoembryonic antigen |
| spellingShingle | Yimin Tang Juanjuan Zhang Huarong Huang Xing He Jiaohong Zhang Min Ou Guobao Li Changchun Zeng Taosheng Ye Lili Ren Yingxia Liu Guoliang Zhang Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion BMC Infectious Diseases Tuberculosis pleural effusion Malignant pleural effusion IFN-γ release assay Adenosine deaminase Carcinoembryonic antigen |
| title | Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| title_full | Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| title_fullStr | Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| title_full_unstemmed | Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| title_short | Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| title_sort | pleural ifn γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion |
| topic | Tuberculosis pleural effusion Malignant pleural effusion IFN-γ release assay Adenosine deaminase Carcinoembryonic antigen |
| url | http://link.springer.com/article/10.1186/s12879-018-3654-z |
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