Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh India.
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh India.
Cytokine. 2022 Nov;159:156019. doi: 10.1016/j.cyto.2022.156019. Epub 2022 Aug 30.
The diagnostic performance of pleural fluid interleukins as potential biomarkers for tuberculous pleural effusion (TPE) remains unclear. We assessed the diagnostic accuracy of various interleukins in the pleural fluid for TPE and evaluated their ability to differentiate TPE from other effusions.
We queried the PubMed and Embase databases for studies indexed till October 2021. We included studies that (a) provided information regarding sensitivity and specificity of pleural fluid interleukins for diagnosing TPE, or (b) compared pleural fluid interleukin levels between TPE and malignant or parapneumonic effusions. We used hierarchical summary receiver operating characteristic plots to model summary sensitivity and specificity. Random effects modeling was employed to pool standardized mean differences (SMD) across descriptive studies comparing TPE and other effusions.
We included 80 publications in our review; most were small and of poor quality. All interleukins except interleukin-27 (interleukins 1-beta, 2, 4, 6, 8, 10, 12, 12p40, 13, 18, 33) showed poor diagnostic accuracy and inconsistent discrimination of TPE from other effusions. The summary estimates for sensitivity, specificity, and diagnostic odds ratio were 0.94 (95 % CI 0.85-0.98), 0.97 (95 % CI 0.93-0.99), and 507.13 (95 % CI 130.66-1968.34) respectively for pleural fluid interleukin-27. Mean pleural fluid interleukin-27 levels in TPE were significantly higher than malignant (summary SMD 3.72, 95 % CI 2.81-4.63) or parapneumonic (summary SMD 2.45, 95 % CI -1.80-3.09) effusions.
Pleural fluid interleukins are poor diagnostic biomarkers for TPE. Only pleural fluid interleukin-27 exhibited good accuracy in diagnosing TPE and needs further evaluation.
胸腔积液中白细胞介素作为结核性胸腔积液（TPE）潜在生物标志物的诊断性能仍不清楚。我们评估了胸腔积液中各种白细胞介素对 TPE 的诊断准确性，并评估了它们区分 TPE 与其他胸腔积液的能力。
我们在 PubMed 和 Embase 数据库中检索了截至 2021 年 10 月的索引研究。我们纳入了（a）提供关于胸腔积液白细胞介素诊断 TPE 的敏感性和特异性信息的研究，或（b）比较 TPE 和恶性或类肺炎性胸腔积液中胸腔积液白细胞介素水平的研究。我们使用分层汇总受试者工作特征图来模拟汇总敏感性和特异性。使用随机效应模型对比较 TPE 和其他胸腔积液的描述性研究进行标准化均数差（SMD）合并。
我们的综述纳入了 80 篇出版物；大多数研究规模较小且质量较差。除白细胞介素-27（白细胞介素 1-β、2、4、6、8、10、12、12p40、13、18、33）外，所有白细胞介素对 TPE 的诊断准确性均较差，且不能很好地区分 TPE 与其他胸腔积液。敏感性、特异性和诊断优势比的汇总估计值分别为胸腔液白细胞介素-27 的 0.94（95%置信区间 0.85-0.98）、0.97（95%置信区间 0.93-0.99）和 507.13（95%置信区间 130.66-1968.34）。TPE 中胸腔液白细胞介素-27 的平均水平明显高于恶性（汇总 SMD 3.72，95%置信区间 2.81-4.63）或类肺炎性（汇总 SMD 2.45，95%置信区间-1.80-3.09）胸腔积液。
胸腔液白细胞介素是 TPE 的诊断生物标志物较差。只有胸腔液白细胞介素-27 在诊断 TPE 方面具有较好的准确性，需要进一步评估。
