Evaluation And Clinical Application Of T-SPOT.TB And CLEIA In The Detection Of Tuberculosis Infection

Purpose:1.To explore the value of detecting Mycobacterium tuberculosis in the diagnosis of tuberculosis by T-cell detection(immunospot method)(T-SPOT.TB)and chemiluminescence enzyme immunoassay(CLEIA).2.To explore the value of T-SPOT.TB in the detection of Mycobacterium tuberculosis in latent rheumatic tuberculosis infection in rheumatic immune diseases and cancer patients.Methods:1.From January 2016 to July 2017,a total of 362 patients were admitted to the China-Japan Union Hospital of JiLin University,of which 138 patients were eventually diagnosed with tuberculosis through imaging,bacteriological and pathological examinations,including 76 males and 62 females.Inclusion criteria meet the diagnostic criteria for tuberculosis.A total of 224 patients were eventually screened for non-tuberculosis,including 121 males and 103 females.All patients were tested for Mycobacterium tuberculosis by T-SPOT.TB and CLEIA.Exclusion criteria:(1)recently used immunosuppressant therapy;(2)with severe liver or renal impairment;(3)Human immunodeficiency virus(HIV)antibody test is positive.2.In the same period,T-SPOT.TB test were performed on a total of240 rheumatic immune diseases and tumor patients hospitalized in our hospital to determine if there were latent infection with Mycobacterium tuberculosis.A total of 124 cases of patients with rheumatic immune diseases were involved;116 cases were tumor patients.Results:1.The sensitivity of the T-SPOT.TB assay was 87.0% and the specificity was 91.0%;the CLIA assay had a sensitivity of 84.8% and a specificity of 90.1%.The positive and negative predictive values of T-SPOT.TB assay were 85.1% and 91.9%,respectively.The positive and negative predictive values of CLIA were 84.2% and 90.5%,respectively.There was no statistical difference between the two detection methods(P>0.05).2.The positive rates of T-SPOT.TB detection in rheumatic immune diseases and tumor patients were 28.2% and 26.7%,respectively.Conclusions:1.The sensitivity and specificity of detection of Mycobacterium tuberculosis by T-SPOT.TB and chemiluminescence enzyme immunoassay are high,and they have important reference values in the diagnosis of tuberculosis.2.Both methods have high negative predictive value.Excluding the diagnosis of tuberculosis based on the test results also has a good guiding significance for the diagnosis and treatment of clinical diseases.3.The proportions of latent TB infections in rheumatic immune diseases and cancer patients are relatively high.Screening for Mycobacterium tuberculosis infection by T-SPOT.TB method has important guiding significance for the diagnosis and treatment medication of clinical diseases.