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Pleural fluid soluble Fas ligand and tuberculous pleural effusion: a prospective diagnostic test accuracy study

Xu-Hui Wen1,2, Jian-Xun Wen3, Lan Mu1

  • 1Department of Parasitology, The Basic Medical Sciences College of Inner Mongolia Medical University, Hohhot, China.

Journal of Thoracic Disease
|January 22, 2024
PubMed
Abstract

Insights

Soluble Fas ligand (sFasL) shows moderate diagnostic accuracy for tuberculous pleural effusion (TPE). While not superior to adenosine deaminase (ADA), sFasL offers a net benefit in diagnosing TPE in patients with undiagnosed pleural effusion.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Biomarker Research

Background:

  • Tuberculous pleural effusion (TPE) diagnosis is challenging.
  • Traditional markers like adenosine deaminase (ADA) have limitations.
  • Soluble Fas ligand (sFasL) shows potential for TPE diagnosis.

Purpose of the Study:

  • Evaluate the additional diagnostic value of pleural fluid sFasL for TPE.
  • Assess the net benefit of sFasL in diagnosing TPE.
  • Investigate factors influencing sFasL diagnostic accuracy.

Main Methods:

  • Prospective enrollment of 211 patients with undiagnosed pleural effusion.
  • Measurement of pleural fluid sFasL concentration using ELISA.
  • Analysis of diagnostic accuracy and net benefit using ROC curves, DCA, NRI, and IDI.

Main Results:

  • sFasL demonstrated moderate diagnostic accuracy (AUC=0.74) for TPE.
  • ADA showed higher accuracy (AUC=0.80).
  • sFasL analysis indicated a net benefit and significant improvement in reclassification (NRI=0.36, P=0.05).

Conclusions:

  • Pleural fluid sFasL has moderate diagnostic accuracy for TPE.
  • sFasL provides a net benefit in diagnosing TPE.
  • sFasL may complement traditional markers like ADA for TPE diagnosis.
Keywords:
Tuberculous pleural effusion (TPE)diagnostic accuracysensitivitysoluble Fas ligand (sFasL)specificity

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