Accuracy of interleukin-27 in diagnosing tuberculous pleural effusion: Age should be considered

Hong-Zhe Zhu; Yan Niu; Jian-Xun Wen; Cheng Yan; Su-Na Cha; Yue Gao; Xu-Lei Hao; Wen-Jie Hou; Li Yan; Ting-Wang Jiang; Zhi-De Hu; Wen-Qi Zheng

doi:10.1016/j.cyto.2024.156844

Accuracy of interleukin-27 in diagnosing tuberculous pleural effusion: Age should be considered

Cytokine. 2024 Dec 31:186:156844. doi: 10.1016/j.cyto.2024.156844. Online ahead of print.

Authors

Hong-Zhe Zhu¹, Yan Niu², Jian-Xun Wen², Cheng Yan³, Su-Na Cha³, Yue Gao¹, Xu-Lei Hao³, Wen-Jie Hou³, Li Yan⁴, Ting-Wang Jiang⁵, Zhi-De Hu⁶, Wen-Qi Zheng⁷

Affiliations

¹ Department of Laboratory Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; Department of Parasitology, the Basic Medical Sciences College of Inner Mongolia Medical University, Hohhot 010107, China; Key Laboratory for Biomarkers, Inner Mongolia Medical University, Hohhot 010050, China.
² Medical Experiment Center, the College of Basic Medicine, Inner Mongolia Medical University, Hohhot 010030, China.
³ Department of Laboratory Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; Key Laboratory for Biomarkers, Inner Mongolia Medical University, Hohhot 010050, China.
⁴ Key Laboratory for Biomarkers, Inner Mongolia Medical University, Hohhot 010050, China; Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
⁵ Department of Key Laboratory, Affiliated Changshu Hospital of Nantong University, Changshu 215500, China.
⁶ Department of Laboratory Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; Key Laboratory for Biomarkers, Inner Mongolia Medical University, Hohhot 010050, China. Electronic address: [email protected].
⁷ Department of Laboratory Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; Department of Parasitology, the Basic Medical Sciences College of Inner Mongolia Medical University, Hohhot 010107, China; Key Laboratory for Biomarkers, Inner Mongolia Medical University, Hohhot 010050, China. Electronic address: [email protected].

PMID: 39742701
DOI: 10.1016/j.cyto.2024.156844

Abstract

Background: Tuberculous pleural effusion (TPE) diagnosis still faces many difficulties and challenges. Some studies have shown that pleural interleukin -27 (IL-27) had a diagnostic potential for TPE. However, their findings are not always consistent. This study aimed to investigate the diagnostic accuracy of pleural IL-27 for TPE.

Methods: We prospectively enrolled 211 patients with undiagnosed pleural effusion. Effusion Mycobacterium tuberculosis (Mtb) culture, Ziehl-Neelsen staining, biopsy, and response to antituberculosis therapy were used to define TPE. The pleural IL-27 levels were determined by enzyme-linked immunosorbent assay (ELISA). A receiver operating characteristic curve (ROC) with the area under the curve (AUC) was used to evaluate the diagnostic accuracy of IL-27 for TPE. In addition, we investigated the influence of age on the diagnostic performance of IL-27 by resampling patients with different upper age limits in the inclusion criteria.

Results: Among the 211 enrolled participants, 33 were TPE and 178 were non-TPE. The mean concentration of IL-27 in TPE patients was significantly higher than that of non-TPE patients. The AUC of IL-27 was 0.76 (95 %CI: 0.67-0.86). At the threshold of 500 pg/mL, the sensitivity and specificity of IL-27 were 0.26 (95 %CI: 0.20-0.33) and 0.91 (95 %CI:0.76-0.97), respectively. The AUC of IL-27 is 0.84 in patients with an upper age limit of 70. Still, it decreased to 0.76 in patients with an upper age limit of 75.

Conclusion: Age can affect the diagnostic performance of IL-27 for TPE.

Keywords: Age; Diagnostic accuracy; Interleukin-27 (IL-27); Tuberculous pleural effusion (TPE).