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Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A

Qing Liu, Yan-Xia Yu, Xiao-Juan Wang

    Respiration; International Review of Thoracic Diseases
    |March 15, 2018
    PubMed
    Abstract

    Insights

    Interleukin-27 (IL-27) assays show high accuracy in distinguishing tuberculous pleurisy (TPE) from malignant pleural effusion (MPE). This diagnostic tool offers high sensitivity and specificity for TPE diagnosis.

    Area of Science:

    • Medical Diagnostics
    • Biomarker Research
    • Pulmonology

    Background:

    • Pleural effusion diagnosis requires accurate differentiation between tuberculous pleurisy (TPE) and malignant pleural effusion (MPE).
    • Interleukin-27 (IL-27) levels are significantly higher in TPE compared to MPE, suggesting its potential as a diagnostic marker.

    Purpose of the Study:

    • To determine the diagnostic accuracy of IL-27 for differentiating TPE from MPE using a meta-analysis.
    • To evaluate the sensitivity, specificity, and overall performance of IL-27 assays in distinguishing these two conditions.

    Main Methods:

    • A meta-analysis was conducted on 7 case-control studies involving 550 patients (285 TPE, 265 MPE).
    • Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated.
    • A summary receiver operating characteristic (SROC) curve was used to assess overall test performance.

    Main Results:

    • IL-27 demonstrated high diagnostic performance with a summary SEN of 0.93 and SPE of 0.97.
    • The positive likelihood ratio was 25.88 and the negative likelihood ratio was 0.07, indicating strong discriminatory power.
    • The area under the SROC curve was 0.99, with a maximal joint SEN and SPE of 0.95.

    Conclusions:

    • IL-27 determination is a highly accurate biomarker for diagnosing TPE and differentiating it from MPE.
    • The test exhibits very high sensitivity and specificity, making it a valuable diagnostic tool.
    • Results of IL-27 assays should be interpreted alongside clinical findings and conventional diagnostic tests.
    Keywords:
    Interleukin-27Meta-analysisTuberculous/malignant pleural effusion

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