ArticleThe Korean journal of internal medicine2022
Laboratory and radiological discrimination between tuberculous and malignant pleural effusions with high adenosine deaminase levels.
Article in The Korean journal of internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- A Strong Correlation Between Pleural Fluid and Serum C-Reactive Protein Levels Across a Spectrum of Pleural Effusions.Journal of clinical medicine research · 2026Article
- Diagnostic performance of adenosine deaminase activity in pleural fluid in tuberculous pleural effusion and relevant factors: a single-center experience with 1,491 consecutive patients.BMC pulmonary medicine · 2025Article
- Diagnostic Efficacy of C-Reactive Protein in Differentiating Various Causes of Exudative Pleural Effusion: Disease Research Should Not Be Exclusive to the Wealthy.Advances in respiratory medicine · 2025Article
- Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40-70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups.Journal of Korean medical science · 2025Article
- Etiology of exudative pleural effusion among adults: differentiating between tuberculous and other causes, a multicenter prospective cohort study.IJID regions · 2024Review
- Added value of 40 keV virtual monoenergetic images for diagnosing malignant pleural effusion on chest CT.Japanese journal of radiology · 2024Article
- Clinical significance of pleural fluid lactate dehydrogenase/adenosine deaminase ratio in the diagnosis of tuberculous pleural effusion.BMC pulmonary medicine · 2024Article
- Features which discriminate between tuberculosis and haematologic malignancy as the cause of pleural effusions with high adenosine deaminase.Respiratory research · 2024Observational
- ADA as main biochemical marker in patients with tuberculous effusion.Journal of medical biochemistry · 2023Article
- Differentiating between tuberculous and non-tuberculous pleural effusions using the pleural fluid ratio of 10× adenosine deaminase/lactate dehydrogenase.Journal of thoracic disease · 2023Article
- Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram.Frontiers in oncology · 2021Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsPleural fluid adenosine deaminase (ADA) levels are useful in discriminating tuberculous pleural effusions (TPEs) from malignant pleural effusions (MPEs). However, some patients with MPE exhibit high-ADA levels, which may mimic TPEs. There is limited data regarding the differential diagnosis between high-ADA MPE and high-ADA TPE. This study aimed to identify the predictors for distinguishing high-ADA MPEs from high-ADA TPEs.
methodsPatients with TPE and MPE with pleural fluid ADA levels ≥ 40 IU/L were included in this study. Clinical, laboratory, and radiological data were compared between the two groups. Independent predictors and their diagnostic performance for high-ADA MPEs were evaluated using multivariate logistic regression analysis and receiver operating characteristic curve.
resultsA total of 200 patients (high-ADA MPE, n = 30, and high-ADA TPE, n = 170) were retrospectively included. In the multivariate analysis, pleural fluid ADA, pleural fluid carcinoembryonic antigen (CEA), and pleural nodularity were independent discriminators between high-ADA MPE and high-ADA TPE groups. Using pleural ADA level of 40 to 56 IU/L (3 points), pleural CEA level ≥ 6 ng/mL (6 points), and presence of pleural nodularity (3 points) for predicting high-ADA MPEs, a sum score ≥ 6 points yielded a sensitivity of 90%, specificity of 96%, positive predictive value of 82%, negative predictive value of 98%, and area under the receiver operating characteristic curve of 0.965.
conclusionA scoring system using three parameters may be helpful in guiding the differential diagnosis between high-ADA MPEs and high-ADA TPEs.
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