Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis.
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.
Jiang
Jing
J
Institute of Respiratory Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.
Shi
Huan-Zhong
HZ
Liang
Qiu-Li
QL
Qin
Shou-Ming
SM
Qin
Xue-Jun
XJ
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
D015415:Biomarkers; D007371:Interferon-gamma