Pleural fluid soluble Fas ligand and tuberculous pleural effusion: a prospective diagnostic test accuracy study.
J Thorac Dis
; 15(12): 6493-6501, 2023 Dec 30.
Article
de En
| MEDLINE
| ID: mdl-38249869
ABSTRACT
Background:
The diagnosis of tuberculous pleural effusion (TPE) is challenging for pulmonologists. Adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin-27 (IL-27) have some limitations for diagnosing TPE. Soluble Fas ligand (sFasL) had a high diagnostic value for TPE. However, it remains unknown (I) whether sFasL has an additional diagnostic value to the traditional markers (e.g., ADA); (II) whether sFasL provides a net benefit in patients with undiagnosed pleural effusion; (III) factors affecting the diagnostic accuracy of sFasL for TPE. This study aimed to evaluate the additional diagnostic value and benefit of pleural fluid sFasL for TPE.Methods:
We prospectively enrolled 211 patients with undiagnosed pleural effusion. The concentration of sFasL in pleural fluid was measured by an enzyme-linked immunosorbent assay (ELISA). The diagnostic accuracy and net benefit of sFasL and ADA for TPE were analyzed by a receiver operating characteristic (ROC) curve, decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discriminant improvement (IDI).Results:
The area under the ROC curves (AUCs) of sFasL and ADA were 0.74 (95% CI 0.65-0.83) and 0.80 (95% CI 0.71-0.90), respectively. The decision curve of sFasL revealed net benefit. The continuous NRI and IDI of sFasL were 0.36 (0.00-0.72, P=0.05) and 0.02 (-0.01-0.06, P=0.18), respectively.Conclusions:
Pleural fluid sFasL has moderate diagnostic accuracy for TPE.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Type d'étude:
Diagnostic_studies
/
Prognostic_studies
Langue:
En
Journal:
J Thorac Dis
/
J. thorac. dis. (Print)
/
Journal of thoracic disease (Print)
Année:
2023
Type de document:
Article
Pays d'affiliation:
Chine
Pays de publication:
Chine