Abstract
BackgroundTo investigate the correlation between pleural fluid interleukin-33 (IL-33) and adenosine deaminase (ADA) and peripheral blood tuberculosis T cell spot detection (T-SPOT.TB), and the combined value of the three tests for the diagnosis of tuberculous pleurisy.Methods79 patients with pleural effusion admitted from June 2017 to December 2018 were enrolled. They were divided into tuberculous pleural effusion (TPE) group (57 cases, 72.2%) and malignant pleural effusion group (17 cases, 21.5%), pneumonia-like pleural effusion group (5 cases, 6.3%). Correlation between pleural fluid IL-33, pleural effusion ADA and peripheral blood T-SPOT.TB was analyzed, comparison of the three separate and combined diagnostic efficacy was also performed.ResultsThe levels of IL-33, ADA and peripheral blood T-SPOT.TB in patients with TPE were significantly higher than those in non-TPE (P < 0.001). The level of pleural fluid IL-33 was positively correlated with pleural effusion ADA and peripheral blood T-SPOT.TB. The Area under the ROC curve (AUC) of TPE diagnosed by pleural IL-33, ADA and peripheral blood T-SPOT.TB were 0.753, 0.912 and 0.865, respectively. AUC for combined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB is the largest, with a value of 0.962. Specificity is 100% and sensitivity is 88.5%.ConclusionCombined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB can improve the diagnostic efficacy of tuberculous pleurisy.
Highlights
To investigate the correlation between pleural fluid interleukin-33 (IL-33) and adenosine deaminase (ADA) and peripheral blood tuberculosis T cell spot detection (T-SPOT.TB), and the combined value of the three tests for the diagnosis of tuberculous pleurisy
Levels of IL‐33, ADA, lactate dehydrogenase (LDH) and T‐SPOT.TB in peripheral blood The concentration of IL-33 in the tuberculous pleural effusion (TPE) group (144.60 ± 48.10 ng/ml) was significantly higher compared to the non-TPE group (99.77 ± 35.18 ng/ml; P < 0.01, n = 79)
The results of this study showed that the level of IL-33 in pleural effusion was significantly higher in patients with tuberculous pleurisy than in non-tuberculous pleural effusion
Summary
To investigate the correlation between pleural fluid interleukin-33 (IL-33) and adenosine deaminase (ADA) and peripheral blood tuberculosis T cell spot detection (T-SPOT.TB), and the combined value of the three tests for the diagnosis of tuberculous pleurisy. Pleural biopsy and bacteriological testing are the gold standard for diagnosis of tuberculous pleurisy. Tuberculosis T cell spot detection (T-SPOT.TB) is a kind of interferon-γ release assay (IGRA). Researches [8,9,10] showed that the level of interleukin-33 (IL-33) in pleural fluid was significantly higher in patients with tuberculous pleurisy than in other causes. The combined value of the three tests for the diagnosis of tuberculous pleurisy was investigated to identify the correlation between pleural fluid interleukin-33 (IL-33), adenosine deaminase (ADA)and peripheral blood tuberculosis T cell spot detection (T-SPOT.TB). It is intended to provide a reference for the clinical diagnosis of tuberculous pleurisy
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