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Ogata, Y., Aoe, K., Hiraki, A., Murakami, K., Kishino, D., Chikamori, K., Maeda, T., Ueoka, H., Kiura, K. and Tanimoto, M. (2011) Is Adenosine Deaminase in Pleural Fluid a Useful Marker for Differentiating Tuberculosis from Lung Cancer or Mesothelioma in Japan, a Country with Intermediate Incidence of Tuberculosis? Acta Medica Okayama, 65, 259-263.

has been cited by the following article:

• TITLE: Clinical Application of T-SPOT.TB Using Pleural Effusion as a Diagnostic Method for Tuberculosis Infection

  AUTHORS: Yoshihiro Kobashi, Keiji Mouri, Yasushi Obase, Shigeki Kato, Mikio Oka

  KEYWORDS: T-SPOT.TB, QuantiFERON, Adenosine Deaminase, Pleural Effusion (PE), Peripheral Blood (PB)

  JOURNAL NAME: Open Journal of Respiratory Diseases, Vol.4 No.2, May 2, 2014

  ABSTRACT: Introduction: The objective of this study was the comparison of the results of T-SPOT.TB using pleural effusion (PE) with those of IGRAs using peripheral blood (PB) or other diagnostic methods for the diagnosis of tuberculous (TB) pleurisy. Methods: We measured adenosine deaminase (ADA) in PE, QuantiFERON TB-Gold In-Tube (QFT), and T-SPOT.TB using PB, and T-SPOT.TB using PE. The definite group of TB pleurisy included 12 patients and other disease group 33 patients. Main find-ings: Sensitivity for QFT using PB was 83% and specificity was 85%, sensitivity for T-SPOT.TB using PB was 92% and specificity was 82%, while sensitivity for ADA in PE was 83% and specificity was 76%. When we adopted the same cut-off level of a positive response for T-SPOT.TB as PB using PE, sensitivity for T-SPOT.TB using PE was 100% and specificity was 82%, respectively. Although there were no significant differences among the four diagnostic methods, sensitivity for T-SPOT.TB using PE gave the most accurate diagnosis of TB-definite patients compared to ADA in PE or QFT using PB. Conclusions: If we performed T-SPOT.TB using a local specimen from the infection site, we could obtain a higher sensitivity than IGRAs using PB or ADA in PE and the numbers of ESAT-6 and CFP-10-positive SFCs were 3 to 5 fold higher in PEMCs than in PBMCs. T-SPOT.TB using PE may become a useful diagnostic method for TB pleurisy.