Head-to-Head Comparison of TB-LAMP, Mycobacterial Culture and Adenosine Deaminase for Diagnosis of Pleural Tuberculosis in China

  • Lei Chen Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Aiyan Wang Department of Laboratory Medicine, People's Hospital of Fangzi District
  • Juan Cheng Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Shouhua Han Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Guangfu Liu Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Zhaobao Pan Department of Laboratory Medicine, The Second People's Hospital of Weifang
Keywords: Pleural Tuberculosis, Diagnosis, Lamp, Adenosine Deaminase

Abstract

Objectives: The objective of the prospective single-center study was to investigate the diagnostic performance of Loop-Mediated Amplification test (TB-LAMP), mycobacterial culture and adenosine deaminase (ADA) for diagnosing pleural tuberculosis (TB) from the pleural effusions in a TB-endemic setting. Methods: We retrospectively analyzed patients suspected of having pleural TB in Weifang between March 2018 and October 2019. The PE samples were evaluated by smear microscopy, mycobacterial culture, TB-LAMP and ADA assay. Results: Overall, 170 patients with suggestive of pleural TB were retrospectively reviewed in this study, of which 125 were diagnosed as pleural TB. Among 125 pleural TB cases, 52 cases were identified by TB-LAMP, resulting in a sensitivity of 41.6%. When combing MGIT and TB-LAMP, 13 additional positive cases were detected compared to MGIT culture alone, demonstrating a sensitivity of 56.8%. The mean ADA levels were corelated with age, and the mean ADA value of <35 years group was significantly higher than that of ≥70 years group (p=0.0214). Conclusion: In conclusion, our data demonstrate the promising effectiveness of TB-LAMP in detection of MTB in concentrated PE specimens. The ADA levels are decreased with advanced age, highlighting the urgent need for confirmation of different cut-off values for various age group.

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Published
2023-06-01
Section
Original Research Article