• Sagrario Mayoralas Alises, Patricia Lazo Meneses, Esteban Perez Rodriguez, Carolina Gotera, Deisy Barrios Barreto, Salvador Diaz Lobato, Rosa Mirambeaux Villalona, and Paola Arrieta Narvaez.
• Chest. 2014 Mar 1;145(3 Suppl):274A.

Session TitlePleural Disease/Pleural Effusion PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To assess the discriminatory power of pleural ADA levels in pleural effusions lymphomas. - Define the cutoff level in these cases.MethodsFrom 1994 to October 2011, 2413 consecutive pleural effusions (PE) were studied, following the protocol of the pleura unit and were included in our database. All cases were closed with a final diagnosis according to results of pleural fluid, pleural biopsy, treatment response and outcome.Lymphocitic pleural effusions were identified as lymphocyte cell levels equal to or greater than 50% of its cell count, excluding transudates (cardiac, ascites, nephrotic atelectasis, dialysis). Of the 2413 cases, 874 (36.2%) were defined as lymphocytic effusions, of which 118 (13.5%) were TB and 231 (9.57%) are malignant. ADA levels were analyzed by non-parametric tests, expressed as U / l. Statistical analysis was descriptive means, standard deviations, applying Mann-Whitney test, Miettinen and Taylor method.Results985 from 2413 cases (40,85) were lymphocytic pleural effusions. Trasudates 111 (excluded), and exudates 874 (included). From these, 537 (61.4% ) were men and 337 women, with a mean age 64 years ± 17.60. Of the 874 patients, 118 were TB diagnosis (13.5%) with a ADA level of 46.7 ± 15 and 231 (9,57%) malignancy. The mean age in TB group was 21.8 ± 42.5 years (53.8% were younger than 35 years). In ymphocytic pleural effusions, the ADA cutoff levels ≥ 25 U / l, showed a sensitivity of 89.66% and a specificity of 91.01% to identify TB pleural effusions.ConclusionsThe discriminant cutoff level of ADA in lymphocytic pleural effusions is lower than the overall series (25 UI vs. 35 UI). - High yield was observed in terms of sensitivity and specificity with this ADA cutoff level (25UI).Clinical ImplicationsOnly in countries with a high drugs ressistance, are justified the conventional method with biopsy and culture. -The increase of PPV of ADA in countries with low prevalence of tuberculous is a false argument. The ADA level in malignant pleural effusions is positive false in only 1,5-2,5% of the cases.DisclosureThe following authors have nothing to disclose: Deisy Barrios Barreto, Esteban Perez Rodriguez, Carolina Gotera, Patricia Lazo Meneses, Paola Arrieta Narvaez, Rosa Mirambeaux Villalona, Salvador Diaz Lobato, Sagrario Mayoralas AlisesNo Product/Research Disclosure Information.

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