OBJECTIVE: As Mycobacterium tuberculosis isolation rates in tuberculous effusions are relatively low, several biochemical and immunological markers have been proposed to diagnose tuberculous pleurisy including adenosine deaminase (ADA) and interferon-gamma (IFN-Î³) Here we summarise the literature on ADA and IFN-Î³ as predictors of tuberculous pleurisy. METHODS: After a systematic review of English language studies, we used summary receiver operating characteristic curve (SROC) analysis to determine the cumulative diagnostic accuracy of both markers and Bayes' theorem to calculate post-test probability of disease in settings with different prevalences of tuberculous pleurisy, assessed and reported the quality of primary studies. RESULTS: From 1978 to November 2000, studies containing sufficient data for the determination of both sensitivity and specificity were 31 on ADA, including 4738 patients, and 13 on IFN-Î³, including 1189 patients. SROC curve yielded a maximum joint sensitivity and specificity of 93% for ADA and 96% for IFN-Î³. In the setting of tuberculous effusion prevalence of 5%, 25% and 85%, post-test probability of a negative ADA test were 0.4%, 2.4% and 24%, and 0.22%, 1.2% and 17% for a negative IFN-Î³ test. CONCLUSION: With the caveat that limitations in the design of the studies summarised here may distort estimates of test performance, ADA and IFN-Î³ appear to be reasonably accurate at detecting TB pleurisy.
Greco S., G.E. (2003). Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: A meta-analysis. INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, 7(8), 777-786.
|Tipologia:||Articolo su rivista|
|Citazione:||Greco S., G.E. (2003). Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: A meta-analysis. INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, 7(8), 777-786.|
|Settore Scientifico Disciplinare:||Settore MED/10 - Malattie dell'Apparato Respiratorio|
|Revisione (peer review):||Sì, ma tipo non specificato|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2003|
|Titolo:||Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: A meta-analysis|
|Autori:||Greco S., Girardi E., Masciangelo R., Capoccetta G.B., Saltini C.|
|Appare nelle tipologie:||01 - Articolo su rivista|