Diagnostic Value Of Interleukin 27,Interferon-?,and Adenosine Deaminase In Pleural Effusion For Tuberculous Pleural Effusion

Object: To explore the diagnostic value of pleural effusion interleukin-27(IL-27),interferon-gamma(IFN-?)and adenosine deaminase(ADA)in tuberculous pleural effusion(TPE).Methods:We inculded tuberculous pleural effusion group of 44 cases,20 with malignant pleural effusion,12 with pneumonia pleural effusion,12 with transudative pleural effusion from General Hospital of Ningxia Medical University from January 2016 to July 2017.The concentration of IL-27 and IFN-? in pleural effusion were measured by enzyme-linked immunosorbent assay(ELISA),ADA in pleural effusion was measured by automatic biochemical analyzer.Statistical analysis was performed and the receiver operating characteristic(ROC)curve was drawn to evaluate their diagnostic value for tuberculous pleural effusion.Results:1.The concentrations of IL-27 and IFN-? in tuberculous pleural effusion were significantly higher than the other three groups(P <0.05),the difference considered statistically significant.The concentrations of ADA in tuberculous pleural effusion were higher than the malignant pleural effusion and the transudative pleural effusion group,the difference considered statistically significant(P <0.001).2.The areas under ROC curve of IL-27,IFN-? and ADA were 0.96,0.79 and 0.92,respectively.They had a specificity of 94.4%,89.5% and 92.1% respectively.The sensitivity were 100%,61.4%,78.6% respectively.The cut-off values were 83.4pg/ ml,54.4pg/ ml and 18.75 U /L.3.The combined detection of IL-27,IFN-? and ADA showed an improvement in specificity,the area under ROC curve was 0.95,the sensitivity was 76.2% and the specificity was 97.4%.4.There was a positive correlationbetween IL-27 and IFN-? and ADA respectively(P <0.001).Conclusion:1.the level of IL-27,IFN-?,ADA in tuberculous pleural effusion were significant higher than others pleural effusion,suggest that it can be used as an effective method to the diagnostis of pleural effusion.2.The accuracy,sensitivity,and specificity of IL-27 in tuberculous pleural effusion are higher than that of IFN-? and ADA,which is considered valuable for the diagnosis of tuberculous pleural effusion.3.Combination of IL-27,IFN-? and ADA,showed an increasement in specificity,which is considered the most valuable and accurate for the diagnosis of tuberculous pleural effusion.4 There were positive correlations between IL-27 and IFN-? and ADA,suggest that they may be involved in the pathogenesis of tuberculous pleural effusion in CD4 T lymphocytes and Th1 cell immune response.