Key result
Pleural fluid ADA showed an area under the ROC curve of 0.786 for diagnosing tuberculous pleural effusion, with an optimal cut-off of 30 IU/L yielding 72.2% sensitivity and 81.2% specificity.
Why the study?
What is the diagnostic value and optimal cut-off of pleural fluid ADA for tuberculous pleural effusion in South Khorasan province?
Cross-Sectional (n=255)
No
What is the diagnostic value and optimal cut-off of pleural fluid ADA for tuberculous pleural effusion in South Khorasan province?
Effect estimate: AUC 0.786 (95% CI 0.71-0.86)
p-value: p=<0.001
In South Khorasan province, the optimal cut-off for pleural fluid ADA to diagnose tuberculous pleural effusion is 30 IU/L, which is lower than standard cut-offs, highlighting the need for region-specific values.
Background: Due to variability of pleural fluid ADA measures in pleural tuberculosis, researchers have recommended the necessity of regional studies for determination of specific regional values. Objectives: The purpose of the present study was to evaluate the values of pleural fluid ADA in diagnosis of Tuberculous pleural effusion in South Khorasan province. Methods: A cross-sectional study was conducted on patients > 12 years old with exudative pleural effusion in South Khorasan province (east of Iran). Light criteria were used to define exudative effusion. Total ADA was determined calorimetrically by Diazyme ADA assay. The data were analyzed using t test, ANOVA and χ2 tests through Spss 16 version software. Results: We studied 255 cases including 139 (54.5%) males and 116 (45.5%) females with mean age of 63.8 ± 18 years. There were 36 (14.1%) cases with Tuberculous pleural effusion and 219 (85.9%) cases of non-Tuberculous pleural effusion. Malignant and acute bacterial infection comprise 106 (41.6%) and 29 cases (11.4%), respectively. The mean levels and optimal cut off point of ADA in Tuberculous pleural effusion were40.2 ± 24.7 and 30 IU/L respectively. ADA in Tuberculous pleural effusion showed negative correlation with age (r = -0.40, p = 0.01), but weak positive correlation with fluid protein(r = 0.44, P = 0.007) and LDH (r = 0.32, P = 05). Conclusions: Mean and cut off point of ADA was relatively low in patients with Tuberculous pleural effusion in South Khorasan province. The age of patients and fluid levels of protein, and LDH must be considered in interpretation of pleural fluid ADA levels.
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Mortazavi-Moghaddam et al. (2016) conducted a cross-sectional in Exudative pleural effusion (n=255). Pleural fluid adenosine deaminase (ADA) level vs. Non-tuberculous pleural effusion was evaluated on Diagnostic accuracy (Area Under the ROC Curve) of ADA for tuberculous pleural effusion (AUC 0.786, 95% CI 0.71-0.86, p=<0.001). Pleural fluid ADA showed an area under the ROC curve of 0.786 for diagnosing tuberculous pleural effusion, with an optimal cut-off of 30 IU/L yielding 72.2% sensitivity and 81.2% specificity.
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