The Application Of T-SPOT.TB Assay In The Diagnosis Of Tuberculous Pleurisy

Objective: To explore the clinical application value of T-SPOT.TB assay for tuberculous pleurisy.Methods: One hundred and thirty-five patients with pleural effusion were enrolled at Affiliated Hospital of Zunyi Medical College from December 2014 to February 2016, and were divided into tuberculosis(TB) group(Group A, 79 patients) and non-TB group(Group B, 56 patients). Peripheral blood mononuclear cells(PBMCs) and pleural effusion mononuclear cells(PEMCs) were collected from patients and used simultaneously for T-SPOT.TB assay and the detection of pleural effusion adenosine deaminase(ADA). The number of effector T lymphocytes which can release gamma interferon in the peripheral blood and pleural effusion after stimulation by TB-specific antigen and ADA results were recorded. All data were used for statistical analysis with the SPSS 17.0 software.Results: The sensitivity, specificity, positive and negative predictive values for diagnosis of tuberculous pleurisy using T-SPOT.TB assay(pleural effusion SFCs/peripheral blood SFCs > 3, pleural effusion SFCs ≥120/250000 PEMCs and peripheral blood SFCs ≥10/250000 PBMCs), T-SPOT.TB ROC curve method(230 SFCs/250000 PEMCs) and ADA detection method(pleural effusion ADA >45U/L) were 83.54%, 87.50%, 90.41% and 79.03%; 84.81%, 82.14%, 87.01% and 79.31%; 39.24%, 98.21%, 96.88% and 53.40% respectively. There was no statistically significant difference between T-SPOT.TB assay and T-SPOT.TB ROC curve method(P>0.05), while differences between both methods and ADA test were statistically significant in all parameters(P < 0.05) except the positive predictive value(P > 0.05).Conclusions: T-SPOT.TB assay has higher sensitivity and specificity in the diagnosis of tuberculous pleurisy and may be used as an important laboratory method for diagnosis of tuberculous pleurisy.