The Diagnostic Value Of Pleural Effusion T-SPOT.TB Detection In Tuberculous Pleuritis

Objective Through T-SPOT.TB method to detect patients with tuberculous pleurisy gamma interferon levels of peripheral blood and pleural effusion of gamma interferon levels,fluorescence staining and culture of mycobacterium tuberculosis and pleural effusion adenosine deaminase(ADA),to explore the clinical value of t-spot detection for tuberculous pleurisy with a view to improving the diagnostic efficiency and improving the clinical efficacy of tuberculous pleurisy.Methods 164 cases of clinically confirmed tuberculous pleurisy and 66 cases of non tuberculous pleurisy(control group)were enrolled from guangzhou chest hospital.And the γ-interferon of blood and pleura effusion were detected by TSPOT.TB test from these 230 patients,the pleural effusions were fluorescence staining smeared,Mycobacterium tuberculosis cultured,TB-DNA and adenosine deaminase(ADA)determined at the same time.Results The sensitivity.of Pleural effusion,T-SPOT.TB test to the auxiliary diagnosis TBP was 93.9%,the specificity was 77.3%,and the sensitivity of the MTB-DNA and ADA were 1.8%,24.4%,45.1%,82.9%,and the specificity was 98.4%,96.9%,96.9% and 90.9%,respectively.Conclusion Research results show that T-SPOT.TB test has a higher diagnostic value in tuberculous pleurisy with Pleural effusion,its sensitivity is higher than routine diagnosing methods.Objective Based on the statistical analysis of TBAg/PHA ratio in T-SPOT.TB test and the statistical analysis of ROC curve,the cut-off value of TBAg/PHA ratio which is meaningful for clinical early diagnosis of tuberculosis pleurisy is found,and the application value of TBAg/PHA ratio in the diagnosis of tuberculosis pleurisy in TSPOT.TB test is discussed.Methods The clinical data of 447 patients with pleural effusions in Guangzhou Thoracic Hospital from January 2018 to March 2019 were analyzed retrospectively.the TSPOT.TB of pleural effusions was detected,and the sensitivity,specificity and accuracy were evaluated by diagnostic test.Results316 were TBP while 131 were none-TBP among the 447 patients.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TSPOT.TB test in the diagnosis of TBP were 82.3%,82.4%,82.3%,91.8% and65.9%.When 0.25 was as cut off value for TBAg/PHA ratio,the sensitivity,specificity and AUC were separately 84.8%,93.5%,0.862(95% CI 0.800~0.925).Conclusion The ratio of TBAg/PHA in T-SPOT.TB test of pleural effusions can significantly improve the specificity of diagnosis of TBP,and the diagnostic performance is significantly higher than that of the number of spots in T-SPOT.TB test of pleural effusions.T-SPOT.TB test is simple and rapid in diagnosis,and has certain application value in the early differential diagnosis of TBP.