title: [Comparison of interferon-gamma release assays and adenosine deaminase of pleural fluid for the diagnosis of pleural tuberculosis].
abstract: OBJECTIVE
  To compare the diagnostic performance of interferon gamma releasing assays (T-SPOT. TB) and adenosine deaminase (ADA) in pleural tuberculosis, and therefore to evaluate the value of T-SPOT. TB in a high tuberculosis burden country.
  
  
  METHODS
  From June 2011 to November 2012, 111 patients with pleural fluid in Beijing Chest Hospital, Capital Medical University were enrolled prospectively and categorized as culture/biopsy-confirmed pleural tuberculosis group (n = 59) and non-pleural tuberculosis group (n = 52). Patients with uncertain diagnosis and clinically diagnosed pleural tuberculosis were excluded from the study. Pleural fluid T-SPOT. TB and ADA measurements were performed, in addition to other routine laboratory tests. Continuous variables (spot forming cells, SFCs) were compared using nonparametric Mann-Whitney U test. Comparisons between proportions were performed using Chi-squared test.
  
  
  RESULTS
  The receiver operating characteristic (ROC) curve and cut-off value of pleural fluid T-SPOT. TB were established according to spot forming cells (SFC) between culture/biopsy-confirmed pleural tuberculosis group and non-pleural tuberculosis group (216 SFC/10(6) pleural fluid mononuclear cells). The sensitivity of pleural fluid T-SPOT. TB and ADA was 91.5% (54/59) and 71.2% (42/59), respectively. The specificity was 90.4% (47/52) and 92.0% (46/50), respectively. The sensitivity of pleural fluid T-SPOT. TB was significantly higher than that of ADA (χ(2) = 8.045, P < 0.01). There was no significant difference of specificity between pleural fluid T-SPOT. TB and ADA (χ(2) = 0.000, P > 0.05). The area under the ROC curve was 0.912 for pleural fluid T-SPOT. TB and 0.903 for ADA. The sensitivity of combination diagnosis of ADA and pleural fluid T-SPOT. TB decreased to 67.8% (40/59), but the specificity increased to 100.0% (50/50).
  
  
  CONCLUSIONS
  Pleural fluid T-SPOT. TB are relatively accurate supplementary assays for the diagnosis of pleural tuberculosis in this high tuberculosis burden country, and the combination of pleural fluid ADA and T-SPOT. TB is of diagnostic value.
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Fengjiao
authors.initials: F
authors.lastname: Du
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Pan
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Jia
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Aiying
authors.initials: A
authors.lastname: Xing
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Boping
authors.initials: B
authors.lastname: Du
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors.forename: Shuxiang
authors.initials: S
authors.lastname: Gu
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China. Email: zzd417@163.com.
authors.forename: Zongde
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis*; D000328:Adult; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000175:diagnosis*
chemical_list: D000243:Adenosine Deaminase