The Study About The Value Of Interon-gama Release Assays And Interleukin-6 Detection To Identify The Tuberculous And Malignant Pleural Effusion

Objective:Resarching the value of Interferon-gamma Release Assays(Interon-gama Release Assays,IGRAs))of peripheral blood and pleural effusion?the level of IL-6 in the serum and pleural effusion.Methods:We collected 106 patients with exudative pleural effusion in our hospital during July in 2015 to December in 2016.According to the pathological result and excluded the patients who did not meet the standards,bring 49 tuberculous pleurisy(TPE)patients and 37 malignant pleural effusion(MPE)patients into the experiment eventually.We collected and analyzed the results of the T-SPOT.TB ?IL-6 testing,and compared them in groups and within groups,so we can know the differences between them.What is more,we draw ROC curve,according to it's area,we know the differential diagnosis efficiency of each testing.Besides,we calculated the sensitivity,specificity,accurate rate,positive predictive value,negative predictive value in order to valuate the measurements' the clinical value.Results:1.The number of SFC(Spots forming cell)of T-SPOT.TB in peripheral blood and pleural effusion of the TPE patients were significantly higher than the MPE patients,and for the TPE patients,the number of SFC of T-SPOT.TB in the pleural effusion pleural effusionwere significantly higher than those in the peripheral blood,the differences were statistically significant.2.The level of IL-6 in the serum and pleural effusion of the TPE patients were significantly higher than the MPE patients.and for the TPE patients,the level of IL-6 in the pleural effusion pleural effusion were significantly higher than that in the serum,the differences were statistically significant.3.The the ROC curve's area of the T-SPOT.TB in peripheral blood and in pleural effusion?the level of the IL-6 in the serum and in pleural effusion were 0.709?0.910,0.660?0.875,the T-SPOT.TB in pleural effusion and the IL-6 detection in the pleural effusion had the highest diagnostic value,their sensitivity,specificity,accurate rate,diagnostic threshold were 85.7%?81.1%?83.7%?217/2.5×105,85.7%?78.4%?82.6%?226pg/ml?4.The sensitivity and specificity of parallel combined usage of T-SPOT.TB and IL-6 was 91.8%?62.1%,and it is with no statistically significant difference compared with each text(X~2=1.33,P=0.25;2c=1.33,P=0.25).The sensitivity and specificity of series of combined use of T-SPOT.TB and IL-6 was 79.6%?97.3%?it was higher with statistically significant difference compared with each text(X~2=4.17,P=0.04;X~2=5.14,P=0.02)?Conclusions:1.With the help of the medical thoracoscopy,we could observe the pleural changes of the different kind of the patients.it is an intuitive,efficient,safe testing technology,and it is deserves to be widely applied.2.The T-SPOT.TB,IL-6 testing,especially T-SPOT.TB,IL-6 in pleural effusion,all had certain application value to identify the TPE and MPE.They can be used as the auxiliary examination methods.According to the results of the series of combined use of T-SPOT.TB and IL-6,we can eliminated the TPE patients more accurately.T-SPOT.TB?IL-6 and the series of combined use of T-SPOT.TB and IL-6 be used as the auxiliary examination methods.3.the T-SPOT.TB's price and the technical requirements are high,it's application in the rural poverty areas would be limited.