[Evaluation of the diagnostic value of adenosine deaminase activity in tuberculous pleuritis].
OBJECTIVE
To investigate the clinical value of pleural fluid adenosine deaminase (ADA) activity in differentiating tuberculous pleural effusions (TPE) from malignant effusions.


METHODS
The serum and pleural adenosine deaminase activity of 91 cases confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed. TPE was confirmed in 49 cases and malignant effusion in 42 cases. The optimal cutoff for TPE was determined by using the ROC curve.


RESULTS
The mean pleural ADA was significantly (t = 7.383, P < 0.01) higher in PTE (46 +/- 26) U/L as compared to malignancy (16 +/- 8) U/L, so was the pleural fluid/serum ADA ratio (4.1 +/- 4.0 vs 1.76 +/- 1.2, t = 3.852, P < 0.01), but there was no statistically significant difference between malignant and tuberculous effusion in serum ADA activity [(13 +/- 5) U/L vs (12 +/- 6) U/L, t = 1.582, P > 0.05]. The cutoff value of pleural ADA for PTE was 28.7 U/L, with a sensitivity of 75.5% and a specificity of 95.2%.


CONCLUSIONS
Pleural fluid, but not serum, ADA activity, can be used for the differentiation between tuberculous and malignant pleural effusions.
Yu
Yan-xia
YX
Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China.
Tong
Zhao-hui
ZH
Gong
Juan-ni
JN
Wang
Zhen
Z
Wang
Xiao-juan
XJ
Xu
Li-li
LL
Wu
Yan-bing
YB
Li
Hong-jie
HJ
Wang
Chen
C
D000243:Adenosine Deaminase / Q000032:analysis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000201:enzymology; D012189:Retrospective Studies; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000201:enzymology; D055815:Young Adult
D000243:Adenosine Deaminase