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Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions
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 Ja...
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| Published in: | Clinical biochemistry 2005-12, Vol.38 (12), p.1066-1070 |
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| cites | cdi_FETCH-LOGICAL-c375t-f8ff0dcbbfc67ad9031fcee49b28a67040644ff30fe60f40e09fa75658138e923 |
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| container_title | Clinical biochemistry |
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| creator | Atalay, Figen Ernam, Dilek Hasanoglu, H. Canan Karalezli, Aysegul Kaplan, Özgül |
| description | 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 |
| doi_str_mv | 10.1016/j.clinbiochem.2005.07.009 |
| format | article |
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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 < 0.001). The optimum cut-off levels for PADA and P/S ADA were 15.3 U/L and 0.66 U/L, respectively. ROC analysis confirmed previous recommendations for albumin gradient (12 g/L) and protein gradient (31 g/L). For detecting exudates, the PADA test yielded a sensitivity and specificity of 85.8% and 82.3%, respectively. Sensitivity and specificity of the albumin gradient were found to be 88.5% and 79.3%, and of the protein gradient 85% and 83.2%, respectively. The areas under the curve (AUC) data and accuracy demonstrated similar discriminative properties in the examined tests.
The measurement of PADA is suggested as a reliable test in the separation of pleural exudates from transudates with accuracy similar to that of the albumin gradient and protein gradient.</description><identifier>ISSN: 0009-9120</identifier><identifier>EISSN: 1873-2933</identifier><identifier>DOI: 10.1016/j.clinbiochem.2005.07.009</identifier><identifier>PMID: 16226239</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>Clinical biochemistry, 2005-12, Vol.38 (12), p.1066-1070</ispartof><rights>2005 The Canadian Society of Clinical Chemists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-f8ff0dcbbfc67ad9031fcee49b28a67040644ff30fe60f40e09fa75658138e923</citedby><cites>FETCH-LOGICAL-c375t-f8ff0dcbbfc67ad9031fcee49b28a67040644ff30fe60f40e09fa75658138e923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16226239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Atalay, Figen</creatorcontrib><creatorcontrib>Ernam, Dilek</creatorcontrib><creatorcontrib>Hasanoglu, H. Canan</creatorcontrib><creatorcontrib>Karalezli, Aysegul</creatorcontrib><creatorcontrib>Kaplan, Özgül</creatorcontrib><title>Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions</title><title>Clinical biochemistry</title><addtitle>Clin Biochem</addtitle><description>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 < 0.001). The optimum cut-off levels for PADA and P/S ADA were 15.3 U/L and 0.66 U/L, respectively. ROC analysis confirmed previous recommendations for albumin gradient (12 g/L) and protein gradient (31 g/L). For detecting exudates, the PADA test yielded a sensitivity and specificity of 85.8% and 82.3%, respectively. Sensitivity and specificity of the albumin gradient were found to be 88.5% and 79.3%, and of the protein gradient 85% and 83.2%, respectively. The areas under the curve (AUC) data and accuracy demonstrated similar discriminative properties in the examined tests.
The measurement of PADA is suggested as a reliable test in the separation of pleural exudates from transudates with accuracy similar to that of the albumin gradient and protein gradient.</description><subject>Adenosine deaminase (ADA)</subject><subject>Adenosine Deaminase - analysis</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Area Under Curve</subject><subject>Exudates and Transudates - enzymology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pleura - enzymology</subject><subject>Pleural effusion</subject><subject>Pleural Effusion - classification</subject><subject>Pleural Effusion - diagnosis</subject><subject>Pleural Effusion - enzymology</subject><subject>Sensitivity and Specificity</subject><subject>Transudates</subject><issn>0009-9120</issn><issn>1873-2933</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqNkMFq3DAQhkVJ6G7SvkJRL7nZHUle2TqWJW0CgfaQHIOQpRGrxZa3kh2at4_CbkmOPQ3_8M0M8xHylUHNgMlv-9oOIfZhsjscaw6wqaGtAdQHsmZdKyquhDgjayitSjEOK3KR875E3nTyI1kxybnkQq3J4-8Bl2QGahzGKYeI1KEZQzQZaYh03iHNeDDJzGGKdPJ0TibmxZX8hNRER_Hvv3Q47ULvl1zw_ImcezNk_Hyql-Thx_X99qa6-_Xzdvv9rrKi3cyV77wHZ_veW9kap0AwbxEb1fPOyBYakE3jvQCPEnwDCMqbdiM3HRMdKi4uydVx7yFNfxbMsx5DtjgMJuK0ZC07BQ0HWUB1BG2ack7o9SGF0aRnzUC_utV7_c6tfnWrodVFZJn9cjqy9CO6t8mTzAJsjwCWV58CJp1twGjRhYR21m4K_3HmBY2uku4</recordid><startdate>20051201</startdate><enddate>20051201</enddate><creator>Atalay, Figen</creator><creator>Ernam, Dilek</creator><creator>Hasanoglu, H. Canan</creator><creator>Karalezli, Aysegul</creator><creator>Kaplan, Özgül</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20051201</creationdate><title>Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions</title><author>Atalay, Figen ; Ernam, Dilek ; Hasanoglu, H. Canan ; Karalezli, Aysegul ; Kaplan, Özgül</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-f8ff0dcbbfc67ad9031fcee49b28a67040644ff30fe60f40e09fa75658138e923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adenosine deaminase (ADA)</topic><topic>Adenosine Deaminase - analysis</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Area Under Curve</topic><topic>Exudates and Transudates - enzymology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pleura - enzymology</topic><topic>Pleural effusion</topic><topic>Pleural Effusion - classification</topic><topic>Pleural Effusion - diagnosis</topic><topic>Pleural Effusion - enzymology</topic><topic>Sensitivity and Specificity</topic><topic>Transudates</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Atalay, Figen</creatorcontrib><creatorcontrib>Ernam, Dilek</creatorcontrib><creatorcontrib>Hasanoglu, H. Canan</creatorcontrib><creatorcontrib>Karalezli, Aysegul</creatorcontrib><creatorcontrib>Kaplan, Özgül</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical biochemistry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Atalay, Figen</au><au>Ernam, Dilek</au><au>Hasanoglu, H. Canan</au><au>Karalezli, Aysegul</au><au>Kaplan, Özgül</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions</atitle><jtitle>Clinical biochemistry</jtitle><addtitle>Clin Biochem</addtitle><date>2005-12-01</date><risdate>2005</risdate><volume>38</volume><issue>12</issue><spage>1066</spage><epage>1070</epage><pages>1066-1070</pages><issn>0009-9120</issn><eissn>1873-2933</eissn><abstract>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 < 0.001). The optimum cut-off levels for PADA and P/S ADA were 15.3 U/L and 0.66 U/L, respectively. ROC analysis confirmed previous recommendations for albumin gradient (12 g/L) and protein gradient (31 g/L). For detecting exudates, the PADA test yielded a sensitivity and specificity of 85.8% and 82.3%, respectively. Sensitivity and specificity of the albumin gradient were found to be 88.5% and 79.3%, and of the protein gradient 85% and 83.2%, respectively. The areas under the curve (AUC) data and accuracy demonstrated similar discriminative properties in the examined tests.
The measurement of PADA is suggested as a reliable test in the separation of pleural exudates from transudates with accuracy similar to that of the albumin gradient and protein gradient.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>16226239</pmid><doi>10.1016/j.clinbiochem.2005.07.009</doi><tpages>5</tpages></addata></record> |
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| ispartof | Clinical biochemistry, 2005-12, Vol.38 (12), p.1066-1070 |
| issn | 0009-9120 1873-2933 |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| 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 |
| title | Pleural adenosine deaminase in the separation of transudative and exudative pleural effusions |
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