A variety of pleural biomarkers have been proposed to assist in the diagnosis of TPE, and recent meta-analyses reveal that adenosine deaminase (ADA) and IFN-γ appear to be relatively accurate for TPE.8 Regarding MPE, a cytological examination of the pleural effusion is the main diagnostic method, but the diagnostic sensitivity varies between 30% and 60%, which can not meet the clinical needs.9 The gene discussed is ADA; the disease is Pleural effusion.