title: Diagnostic accuracy of tumor necrosis factor-alpha, interferon-gamma, interleukin-10 and adenosine deaminase 2 in differential diagnosis between tuberculous pleural effusion and malignant pleural effusion.
abstract: BACKGROUND
  The current study was performed to investigate the potential biomarkers for the differential diagnosis of tuberculous pleural effusion (TPE) and malignant pleural effusions (MPE).
  
  
  METHODS
  Among ninety patients (n = 90) involved in the study, 47 with tuberculous pleural effusion aged from 18 to 70 and 43 with secondary malignant pleural effusion aged from 34 to 78. We tested the pleural levels of TNF-α, IFN-γ and IL-10 as well as the enzyme activity of ADA2, and then we compared the differential diagnostic efficiencies of those biochemical parameters with ADA between the two groups.
  
  
  RESULTS
  Our results show that, the concentrations of pleural TNF-α (45.55 ± 15.85 ng/L), IFN-γ (114.97 ± 27.85 ng/L) as well as activities of ADA2 (35.71 ± 10.00 U/L) and ADA (39.39 ± 10.60 U/L) in tuberculous group were significantly higher compared to malignant group. Furthermore, according to the ROC curve analysis the thresholds of TNF-α, IFN-γ, ADA2 and ADA were found to be 30.3 ng/L, 103.65 ng/L, 29.45 U/L, and 39.00 U/L, respectively. TNF-α, IFN-γ and ADA2 yielded better sensitivity, specificity, and accuracy of the diagnosis than ADA. Our investigation further revealed that the combinations of TNF-α and ADA2 further increased the specificity and accuracy for the differential diagnosis.
  
  
  CONCLUSIONS
  In conclusion, we found that TNF-α, IFN-γ, ADA and ADA2 all increased in TPE. Combinations of the TNF-α and ADA2 yielded the best specificity and accuracy for the differential diagnosis of TPE from MPE. Our investigation suggests that the applications of TNF-α together with ADA2 may contribute to more efficient diagnosis strategies in the management of discrimination between tuberculous and malignant pleural effusions.
authors.forename: Mingying
authors.initials: M
authors.lastname: Li
authors.forename: Helin
authors.initials: H
authors.lastname: Wang
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Junxiang
authors.initials: J
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Xinxiang Medical University, No,88 Jiankang Road, Weihui 453100, Henan Province, China. Xiuexi01@yahoo.com.
authors.forename: Xiue
authors.initials: X
authors.lastname: Xi
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis*; D007371:Interferon-gamma / Q000032:analysis*; D016753:Interleukin-10 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis; D015203:Reproducibility of Results; D014396:Tuberculosis, Pleural / Q000175:diagnosis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma; C408373:ADA2 protein, human; D000243:Adenosine Deaminase