Biomarkers for distinguishing tuberculous pleural effusion from non-tuberculosis effusion: a retrospective study

• Published in: BMC infectious diseases Vol. 23; no. 1; pp. 1 - 771
• Main Authors: Fei, Guo, Yijun, Mo, Weijiang, Jin, Huimin, Chen, Fang, Liu
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 08.11.2023; BioMed Central; BMC
• Subjects: Accuracy; Antigens; Area under the curve; BCG; BCG vaccines; Biological markers; Biomarkers; Biopsy; Cellular biology; Diagnosis; Diagnostic systems; Differential diagnosis; Electronic records; Enzymes; Indicators; Mann-Whitney U test; Mycobacterium tuberculosis(Mtb); Parameter identification; Patients; Performance indices; Pleural effusion; Pleural effusions; Pleurisy; Pneumonia; Proteins; Ratios; Regression analysis; Thoracentesis; Tuberculosis; Tuberculous pleural effusion; China
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08781-0

Pleural effusion (PE) is a common clinical feature that presents a diagnostic challenge for clinicians. In this retrospective study, we aimed to assess the biomarkers, ratios, and multiple indicators in serum and Pleural effusion for the differential diagnosis of tuberculous pleural effusion (TPE) from non-tuberculosis effusion (non-TPE). The participants, who were divided into two groups: TPE and non-TPE (MPE and PPE), from Ningbo First Hospital, were incorporated in this study. The clinical and laboratory features were collected and analyzed using logistic regression analysis. Twelve biomarkers and their ratios in serum and PE were investigated for TPE versus non-TPE. Additionally, the value of multiple indicators for joint diagnosis was estimated. Biomarkers and ratios showed good diagnostic performance. The five variables including Serum ADA, IGRA, Effusion ADA, Effusion ADA/Serum ADA and Effusion LDH/Effusion ADA were identified as valuable parameters for differential diagnosis of TPE from non-TPE. The combined diagnosis of the five indexes yielded the highest diagnostic accuracy for TPE with an AUC (0.919), sensitivity (90.30%), and specificity (94.50%). The biomarkers and ratios demonstrated strong diagnostic performance, and the utilization of multiple indicators for joint diagnosis can improve the diagnostic efficacy of tuberculous pleurisy.