title: Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis.
abstract: BACKGROUND
  Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of interferon (IFN)-gamma measurements in pleural fluid for the early diagnosis of tuberculous pleurisy. We conducted a metaanalysis to determine the accuracy of IFN-gamma measurements in the diagnosis of tuberculous pleurisy.
  
  
  METHODS
  After a systematic review of English-language studies, sensitivity, specificity, and other measures of accuracy of IFN-gamma concentrations in the diagnosis of pleural effusion were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall test performance.
  
  
  RESULTS
  Twenty-two studies met our inclusion criteria. The summary estimates for IFN-gamma in the diagnosis of tuberculous pleurisy in the studies included were as follows: sensitivity, 0.89 (95% confidence interval [CI], 0.87 to 0.91); specificity, 0.97 (95% CI, 0.96 to 0.98); positive likelihood ratio, 23.45 (95% CI, 17.31 to 31.78); negative likelihood ratio, 0.11 (95% CI, 0.07 to 0.16); and diagnostic odds ratio, 272.7 (95% CI, 147.5 to 504.2).
  
  
  CONCLUSIONS
  IFN-gamma determination is a sensitive and specific test for the diagnosis of tuberculous pleurisy. The measurement of IFN-gamma levels in pleural effusions is thus likely to be a useful tool for diagnosing tuberculous pleurisy. The results of IFN-gamma assays should be interpreted in parallel with clinical findings and the results of conventional tests.
authors.affiliation: Institute of Respiratory Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jiang
authors.forename: Huan-Zhong
authors.initials: HZ
authors.lastname: Shi
authors.forename: Qiu-Li
authors.initials: QL
authors.lastname: Liang
authors.forename: Shou-Ming
authors.initials: SM
authors.lastname: Qin
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Qin
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D007371:Interferon-gamma