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ID 46851
JaLCDOI
フルテキストURL
著者
Ogata, Yoshiko Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduated School of Medicine, Dentistry and Pharmaceutical Sciences
Aoe, Keisuke Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center
Hiraki, Akio Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduated School of Medicine, Dentistry and Pharmaceutical Sciences
Murakami, Kazuo Department of Respiratory Medicine, NHO Yamaguchi-Ube Medical Center
Kishino, Daizo Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center
Chikamori, Kenichi Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center
Maeda, Tadashi Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center
Ueoka, Hiroshi Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center
Kiura, Katsuyuki Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduated School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
Tanimoto, Mitsune Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduated School of Medicine, Dentistry and Pharmaceutical Sciences
抄録
The objective of this study was to evaluate the utility of the determination of adenosine deaminase (ADA) level in pleural fluid for the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) in Japan, a country with intermediate incidence of tuberculosis (TB). We retrospectively reviewed the clinical records of 435 patients with pleural effusion and investigated their pleural ADA levels as determined by an auto analyzer. ROC analysis was also performed. The study included patients with MPE (n=188), TPE (n=124), benign nontuberculous pleural effusion (n=94), and pleural effusion of unknown etiology (n=29). The median ADA level in the TPE group was 70.8U/L, which was significantly higher than that in any other groups (p<0.05). The area under the curve (AUC) in ROC analysis was 0.895. With a cut-off level for ADA of 36U/L, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.5%, 86.5%, 69.7%, and 93.6%, respectively. As many as 9% of patients with lung cancer and 15% of those with mesothelioma were false-positive with this ADA cutoff setting. Although the ADA activity in pleural fluid can help in the diagnosis of TPE, it should be noted that some cases of lung cancer or mesothelioma show high ADA activity in geographical regions with intermediate incidence of TB, in contrast to high prevalence areas.
キーワード
pleural effusion
adenosine deaminase
tuberculosis
lung cancer
mesothelioma
Amo Type
Original Article
発行日
2011-08
出版物タイトル
Acta Medica Okayama
65巻
4号
出版者
Okayama University Medical School
開始ページ
259
終了ページ
263
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
著作権者
CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Science KeyUT