Pleural fluid soluble Fas ligand and tuberculous pleural effusion : a prospective diagnostic test accuracy study
2023 Journal of Thoracic Disease. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
Journal of thoracic disease - 15(2023), 12 vom: 30. Dez., Seite 6493-6501 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wen, Xu-Hui [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnostic accuracy |
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| Anmerkungen: |
Date Revised 23.01.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.21037/jtd-23-1076 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36740365X |
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| 100 | 1 | |a Wen, Xu-Hui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pleural fluid soluble Fas ligand and tuberculous pleural effusion |b a prospective diagnostic test accuracy study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 2023 Journal of Thoracic Disease. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a Conclusions: Pleural fluid sFasL has moderate diagnostic accuracy for TPE | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Tuberculous pleural effusion (TPE) | |
| 650 | 4 | |a diagnostic accuracy | |
| 650 | 4 | |a sensitivity | |
| 650 | 4 | |a soluble Fas ligand (sFasL) | |
| 650 | 4 | |a specificity | |
| 700 | 1 | |a Wen, Jian-Xun |e verfasserin |4 aut | |
| 700 | 1 | |a Mu, Lan |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Xi-Shan |e verfasserin |4 aut | |
| 700 | 1 | |a Yan, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jin-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Ting-Wang |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Zhi-De |e verfasserin |4 aut | |
| 700 | 1 | |a Niu, Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Wen-Qi |e verfasserin |4 aut | |
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