title: The comparison of pleural fluid TNF-alpha and IL-10 levels with ADA in tuberculous pleural effusion.
abstract: OBJECTIVE
  Our aim was to evaluate the diagnostic value of pleural fluid TNF-alpha and IL-10 levels in tuberculous pleural effusion (TPE) and compare with that of ADA.
  
  
  METHODS
  70 patients were enrolled in the study. Fourteen patients had TPE, 19 patients malignant pleural effusion (MPE), 18 patients complicated parapneumonic effusion (PPE) and 19 patients had transudative pleural effusion.
  
  
  RESULTS
  The pleural fluid TNF-alpha levels were significantly higher in TPE than MPE and transudates. There was no significant difference in pleural fluid IL-10 levels between groups. Among exudative effusions, TNF-alpha was significantly higher in tuberculous group, while there was no difference in IL-10 levels between tuberculous and nontuberculous group. The pleural fluid ADA levels were significantly higher in TPE than other groups. ROC analysis was performed and the optimal cut-off points of TNF-alpha and ADA were 13.3 pg/mL and 41.5 U/L, respectively. The sensitivity of TNF-alpha was 71% and specificity was 66% in the diagnosis of TPE. In contrast, the sensitivity and specificity of ADA was 78% and 86% respectively.
  
  
  CONCLUSIONS
  TNF- alpha is a useful marker in the diagnosis of TPE and IL-10 has no diagnostic value. However, the sensitivity and specificity of TNF-alpha is lower than that of ADA.
authors.affiliation: Ankara University School of Medical Department Chest Diseases, 06100 Cebeci-Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ciledag
authors.forename: A
authors.initials: A
authors.lastname: Kaya
authors.forename: S
authors.initials: S
authors.lastname: Erol
authors.forename: E
authors.initials: E
authors.lastname: Sen
authors.forename: G
authors.initials: G
authors.lastname: Celik
authors.forename: S
authors.initials: S
authors.lastname: Cesur
authors.forename: Y
authors.initials: Y
authors.lastname: Fidan
authors.forename: S
authors.initials: S
authors.lastname: Kinikli
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis; D016066:Pleural Effusion, Malignant / Q000175:diagnosis; D012372:ROC Curve; D014396:Tuberculosis, Pleural / Q000175:diagnosis*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000243:Adenosine Deaminase