Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis

Chest. 2007 Apr;131(4):1133-41. doi: 10.1378/chest.06-2273.

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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / metabolism
  • Confidence Intervals
  • Diagnosis, Differential
  • Humans
  • Interferon-gamma / metabolism*
  • Pleural Effusion / diagnosis
  • Pleural Effusion / etiology
  • Pleural Effusion / metabolism*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tuberculosis, Pleural / complications
  • Tuberculosis, Pleural / diagnosis*
  • Tuberculosis, Pleural / metabolism

Substances

  • Biomarkers
  • Interferon-gamma