Back to Search
Start Over
Influence of age on the diagnostic accuracy of soluble biomarkers for tuberculous pleural effusion: a post hoc analysis
- Source :
- BMC Pulmonary Medicine, Vol 20, Iss 1, Pp 1-9 (2020), BMC Pulmonary Medicine
- Publication Year :
- 2020
- Publisher :
- Research Square Platform LLC, 2020.
-
Abstract
- Background Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. Combining pleural biomarkers with patients’ age may be a valuable method for diagnosing TPE. We sought to evaluate the influence of age on diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing and Wuhan between January 1, 2014 and June 30, 2015, and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 and IFN-γ are excellent biomarkers to differentiate TPE versus non-TPE cases.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Male
medicine.medical_specialty
China
Interleukin-27
Pleural effusion
Gastroenterology
Sensitivity and Specificity
03 medical and health sciences
Interferon-gamma
0302 clinical medicine
Internal medicine
Post-hoc analysis
Cutoff
Medicine
Humans
030212 general & internal medicine
Aged
lcsh:RC705-779
Receiver operating characteristic
Tuberculous pleural effusion
business.industry
Area under the curve
Age Factors
Exudates and Transudates
Tuberculosis, Pleural
lcsh:Diseases of the respiratory system
Middle Aged
medicine.disease
Confidence interval
Pleural Effusion
Adenosine deaminase
030228 respiratory system
ROC Curve
Interleukin 27
Area Under Curve
Cohort
Biomarker (medicine)
Female
business
Biomarkers
Research Article
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- BMC Pulmonary Medicine, Vol 20, Iss 1, Pp 1-9 (2020), BMC Pulmonary Medicine
- Accession number :
- edsair.doi.dedup.....a737fc148892eb1ac5e35cef01f47580