RESUMO
Objective To explore the value of adenosine deaminase (ADA) activity, interferon-gamma (IFN-γ) and IFN-γ induced protein of 10kD (IP-10) levels in pleural effusion for the diagnosis of tuberculous pleuritis. Methods ADA activity, IFN-γ and IP-10 levels in pleural effusion were determined in sixty-three patients with tuberculous pleuritis and 50 patients with malignant pleural effusion. Results The mean levels of ADA, IFN-γ and IP-10 in the tuberculous pleural effusion were significantly higher than those in malignant pleural effusion (P<0.01). When 45U/L was regarded as cut off value for ADA, the sensitivity, specificity and diagnostic odds ratio in the diagnosis of tuberculous pleurisy were 71.4%, 94.0% and 39.17 respectively. When 138.5pg/ml was regarded as cut off value for IFN-γ in tuberculous pleural effusion, the sensitivity, specificity and diagnostic odds ratio were 93.7%, 82.0% and 67.19 respectively. When 9.21μg/ml was regarded as cut off value for IP-10 in tuberculous pleural effusion, the sensitivity, specificity and diagnostic odds ratio were 85.7%, 90.0% and 54.00 respectively. The combined determination of the three markers for the diagnosis of tuberculous pleurisy had a sensitivity of 95.2%, specificity of 96.0% and diagnostic odds ratio of 72.16. Conclusion The accuracy of diagnosis for tuberculous pleurisy can be improved by combined determination of ADA, IFN-γ and IP-10.
