Diagnostic value of nucleic acid amplification tests for tuberculous pleural effusion

Papers of special note have been highlighted as: • of interest; •• of considerable interest

References

• 1. Global Tuberculosis Report. WHO, Geneva, Switzerland (2021).
  Google Scholar
• 2. Global Tuberculosis Report. WHO, Geneva, Switzerland (2020).
  Google Scholar
• 3. Light RW. Update on tuberculous pleural effusion. Respirology 15(3), 451–458 (2010).
  MedlineGoogle Scholar
• 4. Tyagi S, Sharma N, Tyagi JS, Haldar S. Challenges in pleural tuberculosis diagnosis: existing reference standards and nucleic acid tests. Future Microbiol. 12, 1201–1218 (2017). •• This is a comprehensive meta-analysis investigating the diagnostic accuracy of the nucleic acid amplification test for tuberculous pleural effusion.
  CASGoogle Scholar
• 5. Bielsa S, Acosta C, Pardina M, Civit C, Porcel JM. Tuberculous pleural effusion: clinical characteristics of 320 patients. Arch. Bronconeumol. (Engl. Ed.) 55(1), 17–22 (2019).
  MedlineGoogle Scholar
• 6. Trajman A, Pai M, Dheda K et al. Novel tests for diagnosing tuberculous pleural effusion: what works and what does not? Eur. Respir. J. 31(5), 1098–1106 (2008).
  Medline CASGoogle Scholar
• 7. Brisson-Noel A, Aznar C, Chureau C et al. Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation. Lancet 338(8763), 364–366 (1991).
  Medline CASGoogle Scholar
• 8. Jungkind D. Tech.Sight. Molecular testing for infectious disease. Science 294(5546), 1553–1555 (2001).
  Medline CASGoogle Scholar
• 9. Louie M, Louie L, Simor AE. The role of DNA amplification technology in the diagnosis of infectious diseases. CMAJ 163(3), 301–309 (2000).
  Medline CASGoogle Scholar
• 10. Pao CC, Yen TS, You JB, Maa JS, Fiss EH, Chang CH. Detection and identification of Mycobacterium tuberculosis by DNA amplification. J. Clin. Microbiol. 28(9), 1877–1880 (1990).
  Medline CASGoogle Scholar
• 11. Gallo JF, Pinhata JM, Chimara E, Gonçalves MG, Fukasawa LO, Oliveira RS. Performance of an in-house real-time polymerase chain reaction for identification of Mycobacterium tuberculosis isolates in laboratory routine diagnosis from a high burden setting. Mem Inst Oswaldo Cruz 111(9), 545–550 (2016).
  Medline CASGoogle Scholar
• 12. Miller MB, Popowitch EB, Backlund MG, Ager EP. Performance of Xpert MTB/RIF RUO assay and IS6110 real-time PCR for Mycobacterium tuberculosis detection in clinical samples. J. Clin. Microbiol. 49(10), 3458–3462 (2011).
  Medline CASGoogle Scholar
• 13. Villegas MV, Labrada LA, Saravia NG. Evaluation of polymerase chain reaction, adenosine deaminase, and interferon-gamma in pleural fluid for the differential diagnosis of pleural tuberculosis. Chest 118(5), 1355–1364 (2000).
  Medline CASGoogle Scholar
• 14. Pai M, Flores LL, Hubbard A, Riley LW, Colford JM Jr. Nucleic acid amplification tests in the diagnosis of tuberculous pleuritis: a systematic review and meta-analysis. BMC Infect. Dis. 4, 6 (2004).
  MedlineGoogle Scholar
• 15. Che N, Yang X, Liu Z, Li K, Chen X. Rapid detection of cell-free Mycobacterium tuberculosis DNA in tuberculous pleural effusion. J. Clin. Microbiol. 55(5), 1526–1532 (2017).
  Medline CASGoogle Scholar
• 16. Yang X, Che N, Duan H et al. Cell-free Mycobacterium tuberculosis DNA test in pleural effusion for tuberculous pleurisy: a diagnostic accuracy study. Clin. Microbiol. Infect. 26(8), 1089.e1081–1089.e1086 (2020).
  Google Scholar
• 17. Takagi N, Hasegawa Y, Ichiyama S, Shibagaki T, Shimokata K. Polymerase chain reaction of pleural biopsy specimens for rapid diagnosis of tuberculous pleuritis. Int. J. Tuberc. Lung Dis. 2(4), 338–341 (1998).
  Medline CASGoogle Scholar
• 18. Hasaneen NA, Zaki ME, Shalaby HM, El-Morsi AS. Polymerase chain reaction of pleural biopsy is a rapid and sensitive method for the diagnosis of tuberculous pleural effusion. Chest 124(6), 2105–2111 (2003).
  Medline CASGoogle Scholar
• 19. Amer S, Hefnawy AE, Wahab NA, Okasha H, Baz A. Evaluation of different laboratory methods for rapid diagnosis of tuberculous pleurisy. Int. J. Mycobacteriol. 5(4), 437–445 (2016).
  MedlineGoogle Scholar
• 20. Li L, Wang Y, Zhang R et al. Diagnostic value of polymerase chain reaction/acid-fast bacilli in conjunction with computed tomography-guided pleural biopsy in tuberculous pleurisy: a diagnostic accuracy study. Medicine (Baltimore) 98(29), e15992 (2019).
  Medline CASGoogle Scholar
• 21. Wang Z, Xu LL, Wu YB et al. Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion. Respir. Med. 109(9), 1188–1192 (2015).
  MedlineGoogle Scholar
• 22. Lima DM, Colares JK, Da Fonseca BA. Combined use of the polymerase chain reaction and detection of adenosine deaminase activity on pleural fluid improves the rate of diagnosis of pleural tuberculosis. Chest 124(3), 909–914 (2003).
  Medline CASGoogle Scholar
• 23. Michos AG, Daikos GL, Tzanetou K et al. Detection of Mycobacterium tuberculosis DNA in respiratory and nonrespiratory specimens by the Amplicor MTB PCR. Diagn. Microbiol. Infect. Dis. 54(2), 121–126 (2006).
  Medline CASGoogle Scholar
• 24. Kalantri Y, Hemvani N, Chitnis DS. Evaluation of real-time polymerase chain reaction, interferon-gamma, adenosine deaminase, and immunoglobulin A for the efficient diagnosis of pleural tuberculosis. Int. J. Infect. Dis. 15(4), e226–e231 (2011).
  Medline CASGoogle Scholar
• 25. Sankar S, Kuppanan S, Balakrishnan B, Nandagopal B. Analysis of sequence diversity among IS6110 sequence of Mycobacterium tuberculosis: possible implications for PCR based detection. Bioinformation 6(7), 283–285 (2011).
  MedlineGoogle Scholar
• 26. Tadele A, Beyene D, Hussein J et al. Immunocytochemical detection of Mycobacterium tuberculosis complex specific antigen, MPT64, improves diagnosis of tuberculous lymphadenitis and tuberculous pleuritis. BMC Infect. Dis. 14, 585 (2014).
  MedlineGoogle Scholar
• 27. Khosravi AD, Alami A, Meghdadi H, Hosseini AA. Identification of Mycobacterium tuberculosis in clinical specimens of patients suspected of having extrapulmonary tuberculosis by application of nested PCR on five different genes. Front. Cell. Infect. Microbiol. 7, 3 (2017).
  MedlineGoogle Scholar
• 28. Chakravorty S, Sen MK, Tyagi JS. Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. J. Clin. Microbiol. 43(9), 4357–4362 (2005).
  Medline CASGoogle Scholar
• 29. Raj A, Singh N, Gupta KB et al. Comparative evaluation of several gene targets for designing a multiplex-PCR for an early diagnosis of extrapulmonary tuberculosis. Yonsei Med. J. 57(1), 88–96 (2016).
  Medline CASGoogle Scholar
• 30. Rafi W, Venkataswamy MM, Ravi V, Chandramuki A. Rapid diagnosis of tuberculous meningitis: a comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen. J. Neurol. Sci. 252(2), 163–168 (2007).
  Medline CASGoogle Scholar
• 31. Ginesu F, Pirina P, Sechi LA et al. Microbiological diagnosis of tuberculosis: a comparison of old and new methods. J. Chemother. 10(4), 295–300 (1998).
  Medline CASGoogle Scholar
• 32. Gill MK, Kukreja S, Chhabra N. Evaluation of nested polymerase chain reaction for rapid diagnosis of clinically suspected tuberculous pleurisy. J. Clin. Diagn. Res. 7(11), 2456–2458 (2013).
  Medline CASGoogle Scholar
• 33. Gao Y, Ou Q, Huang F et al. Improved diagnostic power by combined interferon-gamma release assay and nested-PCR in tuberculous pleurisy in high tuberculosis prevalence area. FEMS Immunol. Med. Microbiol. 66(3), 393–398 (2012).
  Medline CASGoogle Scholar
• 34. Kuwano K, Minamide W, Kusunoki S et al. Evaluation of nested polymerase chain reaction for detecting mycobacterial DNA in pleural fluid. Kansenshogaku Zasshi 69(2), 175–180 (1995).
  Medline CASGoogle Scholar
• 35. Reechaipichitkul W, Lulitanond V, Sungkeeree S, Patjanasoontorn B. Rapid diagnosis of tuberculous pleural effusion using polymerase chain reaction. Southeast Asian J. Trop. Med. Public Health 31(3), 509–514 (2000).
  Medline CASGoogle Scholar
• 36. Mustafa T, Wergeland I, Baba K, Pathak S, Hoosen AA, Dyrhol-Riise AM. Mycobacterial antigens in pleural fluid mononuclear cells to diagnose pleural tuberculosis in HIV co-infected patients. BMC Infect. Dis. 20(1), 459 (2020).
  Medline CASGoogle Scholar
• 37. Liu KT, Su WJ, Perng RP. Clinical utility of polymerase chain reaction for diagnosis of smear-negative pleural tuberculosis. J. Chin. Med. Assoc. 70(4), 148–151 (2007).
  Medline CASGoogle Scholar
• 38. Montenegro LM, Silva BC, Lima JF et al. The performance of an in-house nested-PCR technique for pleural tuberculosis diagnoses. Rev. Soc. Bras. Med. Trop. 46(5), 594–599 (2013).
  MedlineGoogle Scholar
• 39. Yum HK, Choi SJ. Detection of mycobacterial DNA using nested polymerase chain reaction of pleural biopsy specimens: compared to pathologic findings. Korean J. Intern. Med. 18(2), 89–93 (2003).
  Medline CASGoogle Scholar
• 40. Sharma S, Dahiya B, Sreenivas V et al. Comparative evaluation of GeneXpert MTB/RIF and multiplex PCR targeting mpb64 and IS6110 for the diagnosis of pleural TB. Future Microbiol. 13, 407–413 (2018).
  CASGoogle Scholar
• 41. Bandyopadhyay D, Gupta S, Banerjee S et al. Adenosine deaminase estimation and multiplex polymerase chain reaction in diagnosis of extra-pulmonary tuberculosis. Int. J. Tuberc. Lung Dis. 12(10), 1203–1208 (2008).
  Medline CASGoogle Scholar
• 42. Ehlers S, Ignatius R, Regnath T, Hahn H. Diagnosis of extrapulmonary tuberculosis by Gen-Probe amplified Mycobacterium tuberculosis direct test. J. Clin. Microbiol. 34(9), 2275–2279 (1996).
  Medline CASGoogle Scholar
• 43. Rantakokko-Jalava K, Marjamäki M, Marttila H, Mäkelä L, Valtonen V, Viljanen MK. LCx Mycobacterium tuberculosis assay is valuable with respiratory specimens, but provides little help in the diagnosis of extrapulmonary tuberculosis. Ann. Med. 33(1), 55–62 (2001).
  Medline CASGoogle Scholar
• 44. Irfan M, Idrees F, Jabeen K, Zubairi ABS, Butt S, Hasan R. Accuracy of genotype MTBDRplus line probe assay in patients with tuberculous pleural effusion: comparison with clinical and culture based diagnosis. Infect. Dis. (Lond.) 52(4), 235–241 (2020).
  CASGoogle Scholar
• 45. Mitarai S, Shishido H, Kurashima A, Tamura A, Nagai H. Comparative study of amplicor Mycobacterium PCR and conventional methods for the diagnosis of pleuritis caused by mycobacterial infection. Int. J. Tuberc. Lung Dis. 4(9), 871–876 (2000).
  Medline CASGoogle Scholar
• 46. Horita N, Yamamoto M, Sato T et al. Sensitivity and specificity of Cobas TaqMan MTB real-time polymerase chain reaction for culture-proven Mycobacterium tuberculosis: meta-analysis of 26999 specimens from 17 studies. Sci. Rep. 5, 18113 (2015).
  Medline CASGoogle Scholar
• 47. Ling DI, Flores LL, Riley LW, Pai M. Commercial nucleic-acid amplification tests for diagnosis of pulmonary tuberculosis in respiratory specimens: meta-analysis and meta-regression. PLOS ONE 3(2), e1536 (2008).
  MedlineGoogle Scholar
• 48. Steingart KR, Sohn H, Schiller I et al. Xpert^® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst. Rev. (1), CD009593 (2013).
  MedlineGoogle Scholar
• 49. Automated Real-Time Nucleic Acid Amplification Technology for Rapid and Simultaneous Detection of Tuberculosis and Rifampicin Resistance: Xpert MTB/RIF Assay for the Diagnosis of Pulmonary and Extrapulmonary TB in Adults and Children: Policy Update. WHO, Geneva, Switzerland (2013).
  Google Scholar
• 50. Zifodya JS, Kreniske JS, Schiller I et al. Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Cochrane Database Syst. Rev. 2, CD009593 (2021).
  MedlineGoogle Scholar
• 51. Yu G, Zhong F, Ye B, Xu X, Chen D, Shen Y. Diagnostic accuracy of the Xpert MTB/RIF assay for lymph node tuberculosis: a systematic review and meta-analysis. Biomed. Res. Int. 2019, 4878240 (2019).
  MedlineGoogle Scholar
• 52. Hernandez AV, De Laurentis L, Souza I et al. Diagnostic accuracy of Xpert MTB/RIF for tuberculous meningitis: systematic review and meta-analysis. Trop. Med. Int. Health 26(2), 122–132 (2021).
  Medline CASGoogle Scholar
• 53. Maynard-Smith L, Larke N, Peters JA, Lawn SD. Diagnostic accuracy of the Xpert MTB/RIF assay for extrapulmonary and pulmonary tuberculosis when testing non-respiratory samples: a systematic review. BMC Infect. Dis. 14, 709 (2014).
  MedlineGoogle Scholar
• 54. Denkinger CM, Schumacher SG, Boehme CC, Dendukuri N, Pai M, Steingart KR. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. Eur. Respir. J. 44(2), 435–446 (2014).
  MedlineGoogle Scholar
• 55. Sehgal IS, Dhooria S, Aggarwal AN, Behera D, Agarwal R. Diagnostic performance of Xpert MTB/RIF in tuberculous pleural effusion: systematic review and meta-analysis. J. Clin. Microbiol. 54(4), 1133–1136 (2016).
  Medline CASGoogle Scholar
• 56. Kohli M, Schiller I, Dendukuri N et al. Xpert^® MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance. Cochrane Database Syst. Rev. 8, CD012768 (2018).
  MedlineGoogle Scholar
• 57. Kohli M, Schiller I, Dendukuri N et al. Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst. Rev. 1, CD012768 (2021).
  MedlineGoogle Scholar
• 58. Yu W, Shen Y, Zhu P, Chen D. Head-to-head comparison of the efficacy of Xpert MTB/RIF Ultra and Xpert MTB/RIF for the diagnosis of tuberculous pleurisy: a systematic review and meta-analysis. Medicine (Baltimore) 101(20), e29363 (2022). • This systematic review and meta-analysis compares the diagnostic accuracy of GeneXpert-MTB/RIF Ultra and GeneXpert-MTB/RIF in head-to-head manner.
  MedlineGoogle Scholar
• 59. Tortoli E, Russo C, Piersimoni C et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur. Respir. J. 40(2), 442–447 (2012).
  MedlineGoogle Scholar
• 60. Kim YW, Kwak N, Seong MW et al. Accuracy of the Xpert^® MTB/RIF assay for the diagnosis of extra-pulmonary tuberculosis in South Korea. Int. J. Tuberc. Lung Dis. 19(1), 81–86 (2015).
  Medline CASGoogle Scholar
• 61. Penz E, Boffa J, Roberts DJ et al. Diagnostic accuracy of the Xpert^® MTB/RIF assay for extra-pulmonary tuberculosis: a meta-analysis. Int. J. Tuberc. Lung Dis. 19(3), 278–284 i–iii (2015).
  Medline CASGoogle Scholar
• 62. Huo ZY, Peng L. Is Xpert MTB/RIF appropriate for diagnosing tuberculous pleurisy with pleural fluid samples? A systematic review. BMC Infect. Dis. 18(1), 284 (2018).
  MedlineGoogle Scholar
• 63. Qiu YR, Chen YY, Wu XR et al. Accuracy of Xpert MTB/RIF assay for the diagnosis of tuberculous pleural effusion. J. Clin. Lab. Anal. 36(1), e24185 (2021).
  MedlineGoogle Scholar
• 64. Jiang J, Yang J, Shi Y et al. Head-to-head comparison of the diagnostic accuracy of Xpert MTB/RIF and Xpert MTB/RIF Ultra for tuberculosis: a meta-analysis. Infect. Dis. (Lond.) 52(11), 763–775 (2020).
  Google Scholar
• 65. Christopher DJ, Schumacher SG, Michael JS et al. Performance of Xpert MTB/RIF on pleural tissue for the diagnosis of pleural tuberculosis. Eur. Respir. J. 42(5), 1427–1429 (2013).
  MedlineGoogle Scholar
• 66. Sun W, Zhou Y, Li W et al. Diagnostic yield of Xpert MTB/RIF on contrast-enhanced ultrasound guided pleural biopsy specimens for pleural tuberculosis. Int. J. Infect. Dis. 108, 89–95 (2021)
  MedlineGoogle Scholar
• 67. Li C, Liu C, Sun B et al. Performance of Xpert^® MTB/RIF in diagnosing tuberculous pleuritis using thoracoscopic pleural biopsy. BMC Infect. Dis. 20(1), 840 (2020).
  Medline CASGoogle Scholar
• 68. Du J, Huang Z, Luo Q et al. Rapid diagnosis of pleural tuberculosis by Xpert MTB/RIF assay using pleural biopsy and pleural fluid specimens. J. Res. Med. Sci. 20(1), 26–31 (2015).
  Medline CASGoogle Scholar
• 69. Gao S, Wang C, Yu X et al. Xpert MTB/RIF Ultra enhanced tuberculous pleurisy diagnosis for patients with unexplained exudative pleural effusion who underwent a pleural biopsy via thoracoscopy: a prospective cohort study. Int. J. Infect. Dis. 106, 370–375 (2021).
  MedlineGoogle Scholar
• 70. Lusiba JK, Nakiyingi L, Kirenga BJ et al. Evaluation of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural tuberculosis in a high prevalence HIV/TB setting. PLOS ONE 9(7), e102702 (2014).
  MedlineGoogle Scholar
• 71. WHO meeting report of a technical expert consultation: non-inferiority analysis of Xpert MTB/RIF ultra compared to Xpert MTB/RIF (2017). https://apps.who.int/iris/handle/10665/254792
  Google Scholar
• 72. Chakravorty S, Simmons AM, Rowneki M et al. The new Xpert MTB/RIF Ultra: improving detection of Mycobacterium tuberculosis and resistance to rifampin in an assay suitable for point-of-care testing. mBio 8(4), e00812-17 (2017). • This article investigated the analytical performance of the GeneXpert-MTB/RIF Ultra.
  MedlineGoogle Scholar
• 73. Bisognin F, Lombardi G, Lombardo D, Re MC, Dal Monte P. Improvement of Mycobacterium tuberculosis detection by Xpert MTB/RIF Ultra: a head-to-head comparison on Xpert-negative samples. PLoS One 13(8), e0201934 (2018).
  MedlineGoogle Scholar
• 74. Wang G, Wang S, Yang X et al. Accuracy of Xpert MTB/RIF Ultra for the diagnosis of pleural TB in a multicenter cohort study. Chest 157(2), 268–275 (2020). • This multicenter study compares the diagnostic accuracy of GeneXpert-MTB/RIF Ultra and GeneXpert-MTB/RIF.
  MedlineGoogle Scholar
• 75. Meldau R, Randall P, Pooran A et al. Same-day tools, including Xpert Ultra and IRISA-TB, for rapid diagnosis of pleural tuberculosis: a prospective observational study. J. Clin. Microbiol. 57(9), e00614-19 (2019).
  MedlineGoogle Scholar
• 76. Rice JE, Reis AH Jr, Rice LM, Carver-Brown RK, Wangh LJ. Fluorescent signatures for variable DNA sequences. Nucleic Acids Res. 40(21), e164 (2012).
  Medline CASGoogle Scholar
• 77. Eigner U, Veldenzer A, Holfelder M. Evaluation of the FluoroType MTB assay for the rapid and reliable detection of Mycobacterium tuberculosis in respiratory tract specimens. Clin. Lab. 59(9–10), 1179–1181 (2013).
  MedlineGoogle Scholar
• 78. Haasis C, Rupp J, Andres S et al. Validation of the FluoroType^® MTBDR assay using respiratory and lymph node samples. Tuberculosis (Edinb.) 113, 76–80 (2018).
  MedlineGoogle Scholar
• 79. Hofmann-Thiel S, Hoffmann H. Evaluation of Fluorotype MTB for detection of Mycobacterium tuberculosis complex DNA in clinical specimens from a low-incidence country. BMC Infect. Dis. 14, 59 (2014).
  MedlineGoogle Scholar
• 80. Obasanya J, Lawson L, Edwards T et al. FluoroType MTB system for the detection of pulmonary tuberculosis. ERJ Open Res. 3(2), 00113-2016 (2017).
  MedlineGoogle Scholar
• 81. De Vos M, Derendinger B, Dolby T et al. Diagnostic accuracy and utility of FluoroType MTBDR, a new molecular assay for multidrug-resistant tuberculosis. J. Clin. Microbiol. 56(9), 00113-2016 (2018).
  Google Scholar
• 82. Bielsa S, Bernet A, Civit C, Acosta C, Manonelles A, Porcel JM. FluoroType^® MTB in pleural fluid for diagnosing tuberculosis. Rev. Clin. Esp. (Barc.) 221(3), 139–144 (2021).
  Medline CASGoogle Scholar
• 83. Notomi T, Mori Y, Tomita N, Kanda H. Loop-mediated isothermal amplification (LAMP): principle, features, and future prospects. J. Microbiol. 53(1), 1–5 (2015).
  Medline CASGoogle Scholar
• 84. Nagai K, Horita N, Yamamoto M et al. Diagnostic test accuracy of loop-mediated isothermal amplification assay for Mycobacterium tuberculosis: systematic review and meta-analysis. Sci. Rep. 6, 39090 (2016).
  Medline CASGoogle Scholar
• 85. Yan L, Xiao H, Zhang Q. Systematic review: comparison of Xpert MTB/RIF, LAMP and SAT methods for the diagnosis of pulmonary tuberculosis. Tuberculosis (Edinb.) 96, 75–86 (2016).
  Medline CASGoogle Scholar
• 86. Yang B, Wang X, Li H, Li G, Cao Z, Cheng X. Comparison of loop-mediated isothermal amplification and real-time PCR for the diagnosis of tuberculous pleurisy. Lett. Appl. Microbiol. 53(5), 525–531 (2011).
  Medline CASGoogle Scholar
• 87. Han M, Xiao H, Yan L. Diagnostic performance of nucleic acid tests in tuberculous pleurisy. BMC Infect. Dis. 20(1), 242 (2020).
  MedlineGoogle Scholar
• 88. French DJ, Archard CL, Brown T, McDowell DG. HyBeacon probes: a new tool for DNA sequence detection and allele discrimination. Mol. Cell. Probes 15(6), 363–374 (2001).
  Medline CASGoogle Scholar
• 89. Yan L, Tang S, Yang Y et al. A large cohort study on the clinical value of simultaneous amplification and testing for the diagnosis of pulmonary tuberculosis. Medicine (Baltimore) 95(4), e2597 (2016).
  Medline CASGoogle Scholar
• 90. Cui Z, Wang Y, Fang L et al. Novel real-time simultaneous amplification and testing method to accurately and rapidly detect Mycobacterium tuberculosis complex. J. Clin. Microbiol. 50(3), 646–650 (2012).
  Medline CASGoogle Scholar
• 91. Deng S, Sun Y, Xia H et al. Accuracy of commercial molecular diagnostics for the detection of pulmonary tuberculosis in China: a systematic review. Sci. Rep. 9(1), 4553 (2019).
  MedlineGoogle Scholar
• 92. Zhang Q, Zhou C. Comparison of laboratory testing methods for the diagnosis of tuberculous pleurisy in China. Sci. Rep. 7(1), 4549 (2017).
  MedlineGoogle Scholar
• 93. Nathavitharana RR, Garcia-Basteiro AL, Ruhwald M, Cobelens F, Theron G. Reimagining the status quo: how close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine 78, 103939 (2022).
  Medline CASGoogle Scholar
• 94. Soni A, Guliani A, Nehra K, Mehta PK. Insight into diagnosis of pleural tuberculosis with special focus on nucleic acid amplification tests. Expert Rev. Respir. Med. 16(8), 887–906 (2022).
  Medline CASGoogle Scholar
• 95. Yan Z, Wang H, Mu L, Hu ZD, Zheng WQ. Regulatory roles of extracellular vesicles in immune responses against Mycobacterium tuberculosis infection. World J. Clin. Cases 9(25), 7311–7318 (2021).
  MedlineGoogle Scholar
• 96. Zhao W, Cao XS, Han YL, Wen XH, Zheng WQ, Hu ZD. Diagnostic utility of pleural cell-free nucleic acids in undiagnosed pleural effusions. Clin. Chem. Lab. Med. 60(10), 1518–1524 (2022).
  Medline CASGoogle Scholar
• 97. Sorolla MA, Sorolla A, Parisi E, Salud A, Porcel JM. Diving into the pleural fluid: liquid biopsy for metastatic malignant pleural effusions. Cancers (Basel) 13(11), 2798 (2021).
  Medline CASGoogle Scholar
• 98. Hooper C, Lee YC, Maskell N, BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease guideline 2010. Thorax 65(Suppl.2), ii4–17 (2010). • This is the British Thoracic Society guideline for pleural effusion management.
  MedlineGoogle Scholar
• 99. Liang QL, Shi HZ, Wang K, Qin SM, Qin XJ. Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: a meta-analysis. Respir. Med. 102(5), 744–754 (2008).
  MedlineGoogle Scholar
• 100. Aggarwal AN, Agarwal R, Sehgal IS, Dhooria S. Adenosine deaminase for diagnosis of tuberculous pleural effusion: a systematic review and meta-analysis. PLOS ONE 14(3), e0213728 (2019).
  Medline CASGoogle Scholar
• 101. Palma RM, Bielsa S, Esquerda A, Martinez-Alonso M, Porcel JM. Diagnostic accuracy of pleural fluid adenosine deaminase for diagnosing tuberculosis. Meta-analysis of Spanish studies. Arch. Bronconeumol. (Engl. Ed.) 55(1), 23–30 (2019).
  MedlineGoogle Scholar
• 102. Aggarwal AN, Agarwal R, Sehgal IS, Dhooria S, Behera D. Meta-analysis of Indian studies evaluating adenosine deaminase for diagnosing tuberculous pleural effusion. Int. J. Tuberc. Lung Dis. 20(10), 1386–1391 (2016).
  Medline CASGoogle Scholar