Significance Of CFP-10and ESAT-6Detection For Early Diagnosis Of Tubercular Meningitis And Tuberculous Pleurisy

Tuberculosis is a highly infectious disease infecting one-third of the world population, doserious to human health, especially in developing counties. Tuberculous meningitis is the mostserious kind of extrapulmonary tuberculosis, high mortality rates, severe sequelae on survivors.Tuberculous pleurisy is a commoner one in extrapulmonary tuberculosis, due to low detection rateof bacteriology, still adopt on the medical history, clinical symptoms, then combination the X-raymanifestations and laboratory examination, etc., so make a comprehensive analysis so as to make adiagnosis. Culture filtered protein10(CFP-10) and early-secreted antigenic target6kDa protein(ESAT-6) of Mycobacterium tuberculosis provide a new opportunity for TB diagnosis, Byenzyme linked immunosorbent assay(ELISA) to detect specific parts of the protein can be improvethe diagnosis of tuberculosis. Objective: To evaluate diagnostic utility of ESAT-6and CFP-10ELISA assay for the early diagnosis of tubercular meningitis and (TBM) and tuberculouspleurisy(TBP).Methods: Get the cerebrospinal fluid(CSF) and hydrothorax in29persons withTBM and TBP,30persons with non-TBM and non-TBP, use the ESAT-6and CFP-10ELISAassay to evaluate the result. Then, use polyacrylamide gel to concentrate the CSF andhydrothorax, contrast the result. Result: Before concentration, sensitivity62.1%(95%confidenceinterval[CI],39-76); specificity86.7%(95%CI,69-96) for CFP-10.sensitivity68.9%(95%CI,49-85);specificity90%(95%CI,73-98) for ESAT-6. For both protein sensitivity79.3%(95%CI,60-92);specificity96.7%(95%CI,83-100).After concentration, sensitivity62.1%(95%confidenceinterval[CI],39-76); specificity86.7%(95%CI,69-96). for CFP-10. sensitivity68.9%(95%CI,49-85); specificity90%(95%CI,73-98) for ESAT-6.For both proteinsensitivity89.6%(95%CI,63-98); specificity96.7%（95%CI,83-100). Before or after concentration,there was no statistical difference with the experimental group of ESAT-6and CFP-10forsensitivity and specificity, P>0.05. But significant difference between experimental group andcontrol group of ESAT-6and CFP-10for sensitivity and specificity, p<0.01. Before concentration,Significantly more two proteins in combination rather than a single protein(CFP-10) had positiveresponses, p<0.05. After concentration there was no statistical difference between the two proteinsin combination and single protein either in sensitivity or specificity,P>0.05. Conclusion: ESAT-6and CFP-10ELISA assay has high sensitivity and specificity, and two proteins in combination has a higher accuracy of diagnostic than a single protein(CFP-10), so it is an accurate rapid rule-intest for early TBM and TBP.