Role of Adenosine Deaminase in Pleural Effusions and its Cytological Correlation

ABSTRACT

Diagnosis of pleural diseases creates difficulty due to overlapping features of various benign and malignant conditions. However pleural fluid cytology of closed pleural biopsy specimen is most commonly used procedure to diagnose various pleural diseases in developing country like India. Present study was conducted to establish diagnostic utility of ADA in Pleural Fluids and its correlation with cytological findings. Methods: The present study includes 100 samples of pleural fluid samples taken from patients coming to the Department of Chest and TB, Government Medical College and Hospital, Amritsar with the complaint of pleural effusion. Results: For ADA levels in pleural fluid Sensitivity is 92%, Specificity is 81.33%, Positive predictive value is 62.16% and Negative predictive value is 96.83%. For lymphocyte count in pleural fluid Sensitivity is 100%, Specificity is 16.67%, Positive predictive value is 31.25 % and Negative predictive value is 100%. In Combination of ADA and lymphocyte count to diagnose tubercular pleural effusion Sensitivity is 100%, Specificity is 77.27%, Positive predictive value is 82.14 % and Negative predictive value is 100%. Conclusion: Measurement of ADA level in pleural fluid in combination with the differential count of pleural fluid will give best results to categorize and to rule in the diagnosis of tubercular pleural effusion.