The Comparison of Pleural Fluid TNF-α and IL-10 Levels with ADA in Tuberculous Pleural Effusion

OBJECTIVES: Our aim was to evaluate the diagnostic value of pleural fluid TNF-alpha and IL-10 levels in tuberculous pleural effusion (TPE) and compare with that of ADA. MATERIAL AND METHODS: 70 patients were enrolled in the study. Fourteen patients had TPE, 19 patients malignant pleural effusion (MPE), 18 patients complicated parapneumonic effusion (PPE) and 19 patients had transudative pleural effusion. RESULTS: The pleural fluid TNF-alpha levels were significantly higher in TPE than MPE and transudates. There was no significant difference in pleural fluid IL-10 levels between groups. Among exudative effusions, TNF-alpha was significantly higher in tuberculous group, while there was no difference in IL-10 levels between tuberculous and nontuberculous group. The pleural fluid ADA levels were significantly higher in TPE than other groups. ROC analysis was performed and the optimal cut-off points of TNF-alpha and ADA were 13.3 pg/mL and 41.5 U/L, respectively. The sensitivity of TNF-alpha was 71% and specificity was 66% in the diagnosis of TPE. In contrast, the sensitivity and specificity of ADA was 78% and 86% respectively. CONCLUSION: TNF- alpha is a useful marker in the diagnosis of TPE and IL-10 has no diagnostic value. However, the sensitivity and specificity of TNF-alpha is lower than that of ADA.