Key result
Interleukin 27 demonstrated excellent diagnostic accuracy for tuberculous pleural effusion with an area under the curve of 0.983 (95% CI 0.947-0.997), sensitivity of 96.1%, and specificity of 99.0%.
Why the study?
Does pleural interleukin 27 accurately diagnose tuberculous pleural effusion compared to interferon-gamma and adenosine deaminase?
Cohort (n=274)
Yes
Does pleural interleukin 27 accurately diagnose tuberculous pleural effusion compared to interferon-gamma and adenosine deaminase?
Effect estimate: AUC 0.983 (95% CI 0.947-0.997)
Interleukin 27 demonstrates excellent diagnostic accuracy for tuberculous pleural effusion, comparable to interferon-gamma and superior to adenosine deaminase.
IL-27 merits evaluation as a pleural biomarker for tuberculous effusion; prospective validation against established markers is required before adoption.
BACKGROUND: Accurate differentiating diagnosis is essential for choosing treatment for exudative pleural effusions. OBJECTIVE: To establish the diagnostic accuracy of interleukin 27 for tuberculous pleural effusion (TPE). METHODS: First, the concentrations of pleural interleukin 27, interferon-gamma and adenosine deaminase were compared between 51 patients with TPE and 103 with non-TPEs (Beijing cohort), and their diagnostic values were evaluated. These were further verified in another independent population (Wuhan cohort, n=120). In the second part of the study, we performed a meta-analysis. RESULTS: With a cut-off value of 591.4 ng/L in the Beijing cohort, the area under the curve, sensitivity, specificity, positive predictive value and negative predictive value of interleukin 27 to diagnose TPE were 0.983 (95% CI 0.947 to 0.997), 96.1% (86.5% to 99.5%), 99.0% (94.7% to 100%), 98.0 (89.4 to 99.9) and 98.1 (93.3 to 99.8), respectively. Excellent diagnostic accuracy of interleukin 27 was also found in the Wuhan cohort and was further confirmed in the meta-analysis. The diagnostic performance of interleukin 27 was comparable to that of interferon-gamma and was more accurate than that of adenosine deaminase. Since the post-test probability of a negative result was always <0.1%, a negative test was considered to exclude TPE in all tuberculosis prevalence settings. CONCLUSIONS: Interleukin 27 can be used to diagnose TPE in a high prevalence setting, and a negative result can also be reliably used to rule out TPE in all prevalence settings.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2017) conducted a cohort in Tuberculous pleural effusion (n=274). Interleukin 27 vs. Interferon-gamma and adenosine deaminase was evaluated on Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion (Area under the curve) (AUC 0.983, 95% CI 0.947-0.997). Interleukin 27 demonstrated excellent diagnostic accuracy for tuberculous pleural effusion with an area under the curve of 0.983 (95% CI 0.947-0.997), sensitivity of 96.1%, and specificity of 99.0%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: