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doi:10.1378/chest.06-2273
(Chest. 2007; 131:1133-1141)
© 2007 American College of Chest Physicians
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Diagnostic Value of Interferon-{gamma} in Tuberculous Pleurisy*

A Metaanalysis

Jing Jiang, MD; Huan-Zhong Shi, MD, PhD; Qiu-Li Liang, MD; Shou-Ming Qin, MD and Xue-Jun Qin, MD

* From the Institute of Respiratory Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China.

Correspondence to: Huan-Zhong Shi, MD, Institute of Respiratory Diseases, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi, People’s Republic of China; e-mail: hzshi{at}vip.tom.com

Abstract

Background: Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of interferon (IFN)-{gamma} measurements in pleural fluid for the early diagnosis of tuberculous pleurisy. We conducted a metaanalysis to determine the accuracy of IFN-{gamma} measurements in the diagnosis of tuberculous pleurisy.

Methods: After a systematic review of English-language studies, sensitivity, specificity, and other measures of accuracy of IFN-{gamma} concentrations in the diagnosis of pleural effusion were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall test performance.

Results: Twenty-two studies met our inclusion criteria. The summary estimates for IFN-{gamma} in the diagnosis of tuberculous pleurisy in the studies included were as follows: sensitivity, 0.89 (95% confidence interval [CI], 0.87 to 0.91); specificity, 0.97 (95% CI, 0.96 to 0.98); positive likelihood ratio, 23.45 (95% CI, 17.31 to 31.78); negative likelihood ratio, 0.11 (95% CI, 0.07 to 0.16); and diagnostic odds ratio, 272.7 (95% CI, 147.5 to 504.2).

Conclusions: IFN-{gamma} determination is a sensitive and specific test for the diagnosis of tuberculous pleurisy. The measurement of IFN-{gamma} levels in pleural effusions is thus likely to be a useful tool for diagnosing tuberculous pleurisy. The results of IFN-{gamma} assays should be interpreted in parallel with clinical findings and the results of conventional tests.

Key Words: interferon • pleural effusion • tuberculosis






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