Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions

• Published in: Clinical biochemistry 2005-12, Vol.38 (12), p.1066-1070
• Main Authors: Atalay, Figen, Ernam, Dilek, Hasanoglu, H. Canan, Karalezli, Aysegul, Kaplan, Özgül
• Format: Article
• Language: English
• Subjects: Adenosine deaminase (ADA); Adenosine Deaminase - analysis; Adolescent; Adult; Aged; Aged, 80 and over; Area Under Curve; Exudates and Transudates - enzymology; Female; Humans; Male; Middle Aged; Pleura - enzymology; Pleural effusion; Pleural Effusion - classification; Pleural Effusion - diagnosis; Pleural Effusion - enzymology; Sensitivity and Specificity; Transudates
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2005.07.009

The purpose of this study was to evaluate the usefulness of a new parameter, pleural adenosine deaminase (PADA), for separating transudative pleural effusion from exudative pleural effusion, and to compare the results with other tests (albumin gradient and protein gradient). From November 2001 to January 2003, 359 consecutive patients with pleural effusion who underwent a diagnostic thoracentesis were included in the study. Effusions were individually classified as transudates or exudates after the careful evaluation of all clinical data and biochemical parameters of pleural fluid and serum of patients on the basis of Light's criteria. The means and standard deviations of PADA, pleural/serum ADA (P/S ADA) ratio, albumin gradient and protein gradient were evaluated for transudative and exudative effusions. The best cut-off values for each test were identified by using the receiver operating characteristic (ROC) curve. The optimum cut-off level was determined by selecting points of test values that provided the greatest sum of sensitivity and specificity. There were 113 transudates and 246 exudates. For each test, differences in mean value between the transudate group and the exudate group were statistically significant ( t test, P