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Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions

Most of pleural effusions are caused by tuberculosis and malignant tumor. Difficult sampling and bacterial sparing nature of these diseases challenge doctors’ diagnosis in China. This study aimed to develop a new convenient and effective method for the differentiation of tuberculous and malignant pl...

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Autores principales: Zhou, Jiupeng, Yang, Yuanli, Zhang, Yongfeng, Liu, Heng, Dou, Quanli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239664/
https://www.ncbi.nlm.nih.gov/pubmed/35777003
http://dx.doi.org/10.1097/MD.0000000000029788
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author Zhou, Jiupeng
Yang, Yuanli
Zhang, Yongfeng
Liu, Heng
Dou, Quanli
author_facet Zhou, Jiupeng
Yang, Yuanli
Zhang, Yongfeng
Liu, Heng
Dou, Quanli
author_sort Zhou, Jiupeng
collection PubMed
description Most of pleural effusions are caused by tuberculosis and malignant tumor. Difficult sampling and bacterial sparing nature of these diseases challenge doctors’ diagnosis in China. This study aimed to develop a new convenient and effective method for the differentiation of tuberculous and malignant pleural effusion. A prospective cohort study of patients hospitalized with malignant (n = 90) and tuberculous (n = 130) pleural effusions from September 2018 to October 2020 was performed. The diagnostic performance of the age to pleural fluid ADA ratio (age/ADA) and other indicators to distinguish tuberculous and malignant pleural effusions was evaluated by receiver operating characteristic (ROC) curve analysis. The areas under the curve (AUC) of age/ADA and pleural fluid ADA were largest. Age/ADA showed sensitivity and specificity of 81.5% (95%CI 73.8%–87.8%) and 97.8% (95%CI 92.2%–99.7%) respectively. The sensitivity and specificity of pleural fluid ADA were 83.1% (95%CI 75.5%–89.1%) and 93.3% (95%CI 86.1%–97.5%) respectively. The positive likelihood [36.69 (95%CI 9.3–144.8)] of age/ADA was significantly higher than that of pleural fluid ADA [12.46 (95%CI 5.7–27.1)]. The AUCs for Cancer Ratio and Cancer Ratio plus were lower and showed a sensitivity of 80.0% (95%CI 72.1%–86.5%), 80.0% (95%CI 70.2%–87.7%) and a specificity of 81.5% (95%CI 73.8%–87.8%), 80.0% (95%CI 70.2%–87.7%) respectively. Age/ADA has a higher diagnostic accuracy than ADA. Age/ADA is a promising diagnostic index for tuberculous and malignant pleural effusion with high sensitivity and specificity, especially the high positive likelihood ratio. The diagnostic accuracy of Cancer Ratio and Cancer Ratio plus are inferior to those of age/ADA and ADA.
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spelling pubmed-92396642022-06-30 Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions Zhou, Jiupeng Yang, Yuanli Zhang, Yongfeng Liu, Heng Dou, Quanli Medicine (Baltimore) Research Article Most of pleural effusions are caused by tuberculosis and malignant tumor. Difficult sampling and bacterial sparing nature of these diseases challenge doctors’ diagnosis in China. This study aimed to develop a new convenient and effective method for the differentiation of tuberculous and malignant pleural effusion. A prospective cohort study of patients hospitalized with malignant (n = 90) and tuberculous (n = 130) pleural effusions from September 2018 to October 2020 was performed. The diagnostic performance of the age to pleural fluid ADA ratio (age/ADA) and other indicators to distinguish tuberculous and malignant pleural effusions was evaluated by receiver operating characteristic (ROC) curve analysis. The areas under the curve (AUC) of age/ADA and pleural fluid ADA were largest. Age/ADA showed sensitivity and specificity of 81.5% (95%CI 73.8%–87.8%) and 97.8% (95%CI 92.2%–99.7%) respectively. The sensitivity and specificity of pleural fluid ADA were 83.1% (95%CI 75.5%–89.1%) and 93.3% (95%CI 86.1%–97.5%) respectively. The positive likelihood [36.69 (95%CI 9.3–144.8)] of age/ADA was significantly higher than that of pleural fluid ADA [12.46 (95%CI 5.7–27.1)]. The AUCs for Cancer Ratio and Cancer Ratio plus were lower and showed a sensitivity of 80.0% (95%CI 72.1%–86.5%), 80.0% (95%CI 70.2%–87.7%) and a specificity of 81.5% (95%CI 73.8%–87.8%), 80.0% (95%CI 70.2%–87.7%) respectively. Age/ADA has a higher diagnostic accuracy than ADA. Age/ADA is a promising diagnostic index for tuberculous and malignant pleural effusion with high sensitivity and specificity, especially the high positive likelihood ratio. The diagnostic accuracy of Cancer Ratio and Cancer Ratio plus are inferior to those of age/ADA and ADA. Lippincott Williams & Wilkins 2022-06-30 /pmc/articles/PMC9239664/ /pubmed/35777003 http://dx.doi.org/10.1097/MD.0000000000029788 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Zhou, Jiupeng
Yang, Yuanli
Zhang, Yongfeng
Liu, Heng
Dou, Quanli
Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title_full Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title_fullStr Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title_full_unstemmed Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title_short Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions
title_sort age : pleural fluid ada ratio and other indicators for differentiating between tubercular and malignant pleural effusions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239664/
https://www.ncbi.nlm.nih.gov/pubmed/35777003
http://dx.doi.org/10.1097/MD.0000000000029788
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