Diagnostic Accuracy of Interleukin-27 in Bronchoalveolar Lavage Fluids for Pulmonary Tuberculosis

Figures & data

Table 1 The Diagnostic Criteria

Sputum-negative PTB	1) Typical pulmonary tuberculous symptoms and chest X-ray findings
	2) Effective antituberculosis treatment
	3) Excluding other non-tuberculous lung diseases
	4) Strong positive manifestation of PPD (5IU), positive serum antituberculosis antibody
	5) Positive tubercle bacillus PCR examination in the sputum
	6) Tuberculosis lesions confirmed by extrapulmonary histopathology
	7) Positive AFB smears in BALFs
	8) Tuberculosis lesions confirmed by bronchial or pulmonary histopathology Three terms of 1 to 6 or any of 7 to 8 can diagnose sputum-negative PTB.^Citation11
Sputum-positive PTB	1) Positive AFB smears performed twice
	2) Positive AFB smears and sputum culture performed once
	3) Imaging that supports TB and positive sputum culture or AFB smears Any of 1 to 3 can diagnose sputum-positive PTB.^Citation40
Previous PTB	1) No tuberculous symptoms such as cough, fever, night sweats
	2) Presence of discrete linear or reticular fibrotic scars, or dense nodules with distinct margins, with or without calcification on chest CT
	3) Interferon gamma release assay and PPD were all negative. Meeting the above criteria can be diagnosed as previous PTB.^Citation41,Citation42

Abbreviations: TB, tuberculosis; PTB, pulmonary tuberculosis; PPD, purified protein derivative; AFB, acid-fast bacillus; PCR, polymerase chain reaction; BALF, bronchoalveolar lavage fluid; CT, computed tomography.

Figure 1 The concentrations of IL-27 and ADA in BALFs of different groups.

Table 2 The Concentrations of IL-27 and ADA in BALFs of Different Groups (Mean±SD)

Groups	Previous PTB (n =24)	Sputum-Positive PTB (n =23)	Sputum-Negative PTB (n =25)	Lung cancer (n =35)	F value	P-value
IL-27 (pg/mL)	5.3±0.4	12.8±3.6*	7.6±0.9^*▲	6.5±0.9^*▲■	80.386	<0.001
ADA (U/L)	0.9±0.0	1.1±0.5*	1.1±0.2*	1.0±0.1*	6.411	<0.001

Notes: *Compared with previous PTB (P<0.001); ^▲Compared with sputum-positive PTB (P<0.001); ^■Compared with sputum-negative PTB (P<0.001).

Figure 2 ROC curve for differential diagnosing PTB from lung cancer.

Notes: PTB including sputum-negative PTB and sputum-positive PTB.

Figure 3 ROC curve for differential diagnosing PTB from previous PTB.

Notes: PTB including sputum-negative PTB and sputum-positive PTB.

Figure 4 ROC curve for differential diagnosing sputum-negative PTB from sputum-positive PTB.

Table 3 Diagnostic Performance of IL-27 and ADA in Differentiating PTB from Lung Cancer

Variables	AUC (95% CI)	Cut-Off	Specificity	Sensitivity	PLR	NLR
IL-27	0.885 (0.817–0.953)	7.867	1.000	0.688	–	0.313
ADA	0.641 (0.521–0.761)	1.087	0.600	0.625	1.563	0.625
IL-27+ADA	0.883 (0.814–0.952)	–	1.000	0.688	–	0.313

Abbreviations: AUC, area under the curve; PLR, positive likelihood ratio; NLR, negative likelihood ratio.

Table 4 Diagnostic Performance of IL-27 and ADA in Differentiating PTB from Previous PTB

Variables	AUC (95% CI)	Cut-Off	Specificity	Sensitivity	PLR	NLR
IL-27	1.000 (1.000–1.000)	6.012	1.000	1.000	–	0.000
ADA	0.851 (0.762–0.939)	0.922	1.000	0.750	–	0.250
IL-27+ADA	1.000 (1.000–1.000)	–	1.000	1.000	–	0.000

Abbreviations: AUC, area under the curve; PLR, positive likelihood ratio; NLR, negative likelihood ratio.

Table 5 Diagnostic Performance of IL-27 and ADA in Differentiating Sputum-Negative PTB from sputum-Positive PTB

Variables	AUC (95% CI)	Cut-Off	Specificity	Sensitivity	PLR	NLR
IL-27	0.988 (0.968–1.000)	8.222	1.000	0.880	–	0.120
ADA	0.557 (0.384–0.730)	1.109	0.609	0.640	1.636	0.591

Abbreviations: AUC, area under the curve; PLR, positive likelihood ratio; NLR, negative likelihood ratio.

Figure 5 Smooth curve fitting for IL-27 with the risk of PTB.

Figure 6 Smooth curve fitting for ADA with the risk of PTB.

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