Abstract

The aim of our study was to compare the diagnostic value of CA 125 as an additive to ADA in the diagnosis of tuberculosis pleurisy cases compared with pleural biopsy. Sixty six pleural effusion cases, 51 male and 15 female, were included in our study. Forty two tuberculous pleurisy cases diagnosed due to clinical, radiological and histopathological evidence constituted the tuberculosis group, while 24 cases with effusion due to a nontuberculous etiology constituted the control group. In the tuberculosis group, which has a definitive diagnosis with pleural biopsy, pleural effusion, CA 125 and ADA, when evaluated together, did not have an effect on the diagnosis (p>0.05). Likewise, the pleural effusion, ADA and serum CA 125 values had no effect on the diagnosis when compared with the pleural biopsy (p>0.05). However, the pleural effusion ADA value alone has a high sensitivity and specificity (90.5% and 95.8% respectively). Its positive predictive value was calculated as 97.4% and negative predictive value was calculated as 85.2%. When the calculated cut-off CA 125 value alone in the pleural effusion was 992.8, it had a sensitivity of 92.9% and specificity of 25 %. In these circumstances, the positive predictive value was 68.4%, and negative predictive value was 66.7%. In conclusion, in the diagnosis of tuberculous pleurisy in countries where tuberculosis prevalence is high, as in our country, pleural effusion ADA value is a valuable diagnostic test, but neither CA 125 alone, nor serum or pleural effusion CA 125 in combination with ADA, have an additive diagnostic value.