Synergistic diagnostic potential of novel biomarkers SYWC and ADA for tuberculous pleural effusion
10.3969/j.issn.1006-5725.2025.15.017
- VernacularTitle:新型标志物胞质型色氨酸-tRNA连接酶与腺苷脱氨酶联合诊断结核性胸腔积液的价值
- Author:
Chunhong FAN
1
;
Wenlong HU
;
Limei ZHU
;
Ruifu YANG
;
Daxia CAI
;
Shaohua LU
;
Xingdong CAI
Author Information
1. 暨南大学附属顺德医院呼吸内科(广东 佛山 528305)
- Publication Type:Journal Article
- Keywords:
tuberculous pleural effusion;
adenosine deaminase;
SYWC;
ROC curve;
diagnostic value
- From:
The Journal of Practical Medicine
2025;41(15):2406-2411
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the respective or synergistic value of cytoplasmic tryptophan-tRNA ligase(WARS1/SYWC)and adenosine deaminase(ADA)in diagnosing tuberculous pleural effusion(TPE).Methods A retrospective analysis was conducted on 120 patients with pleural effusion(64 cases of TPE,56 cases of non-TPE)admitted to the First Affiliated Hospital of Jinan University and its affiliated Shunde Hospital from January 2020 to December 2024.Pleural fluid SYWC levels were identified using enzyme-linked immunosorbent assay(ELISA).Univariate and multivariate logistic regression analyses were performed to identify diagnostic predictors,while receiver operating characteristic(ROC)curves were plotted to assess the diagnostic perfor-mance of individual and combined biomarkers.Results Compared to the non-TPE group,TPE group exhibited significantly younger age,lower pleural CEA,less serum CEA,and lower neutrophil-to-lymphocyte ratio(NLR),but significantly higher levels of pleural ADA,total protein,SYWC,and serum CRP(all P<0.05).Univariate analysis identified age,pleural CEA,carbohydrate antigen 199,ADA,SYWC,serum CEA,and NLR as potential predictors.Multivariate analysis confirmed pleural ADA(OR=1.064,95%CI:1.017～1.228)and SYWC(OR=6.695,95%CI:2.794～16.04)as independent diagnostic factors.At optimal cutoffs,SYWC(16.94 μg/L)demonstrated a sensitivity of 71.80%and specificity of 98.21%,while ADA(36.5 U/L)showed a sensitivity of 93.75%and a specificity of 89.29%.Combined detection increased the sensitivity to 95.56%,the specificity to 98.0%,and the accuracy to 97.87%.ROC analysis revealed an AUC of 0.973(95%CI:0.943～1.000)for the combination,outperforming ADA(0.897)and SYWC(0.938)alone.Conclusion The combi-nation of SYWC and ADA notably enhances diagnostic efficacy for TPE,providing high sensitivity and specificity as a reliable tool for clinical differentiation.
