ADA And T-SPOT.TB For The Application Value Of The Diagnosis Of Tuberculous Pleurisy And ADA Threshold

Objectives:Explore the t-spot.tb test(T-SPOT.TB) joint adenosine deaminase(ADA) test value to the diagnosis of tuberculous pleurisy and evaluate the diagnostic value of ADA take different threshold.Methods:Collection on January 14, 2014, to August 18, 2015 in our hospital 98 cases of patients with pleural effusion, according to the disease under thoracoscope inspection results tuberculous pleural effusion were divided into group(experimental group) and non tuberculous pleural effusion group(control group). After admission were perfect peripheral blood T-SPOT.TB testing and hydrothorax ADA, comparison of peripheral blood T-SPOT.TB, hydrothorax ADA alone with joint detection sensitivity and the degree of specific, on the other hand, ADA test results using ROC curve analysis, comparing sensitivity under different threshold and specific degrees.Results: 1. T-SPOT.TB detection sensitivity is 82.1%, the specific degree of 88.1%, positive predictive value 90.2%, negative predictive value 78.7%; ADA in the diagnosis of 45 U/L for the critical value, the sensitivity was 32.1%, 97.6%, positive predictive value was 94.7%, negative predictive value was 51.9%, took the 20.5 U/L ADA in the diagnosis of a critical value, the sensitivity was 80.4%, 85.7%, positive predictive value was 88.2%, negative predictive value of 76.6%.2. T-SPOT.TB testing sensitivity is better than that of the critical value of ADA when you pick up the 45 U/L detection sensitivity, statistically significant difference(P < 0.05), the critical value of 20.5 U/L ADA detection sensitivity is better than that of the critical value of ADA to detect when take 45 U/L, statistically significant difference(P < 0.05).3. When the T-SPOT.TB and ADA test, the sensitivity was 89.3%, higher than T-SPOT.TB or ADA alone a detection sensitivity.4.4. Hydrothorax ADA took the 20.5 U/L threshold, Youden index, the largest is 0.747; ADA took the 45 U/L threshold, Youden index is 0.310, and the sensitivity is higher than the latter, the difference was statistically difference(P < 0.05).Conclusion: 1.The joint ADA and T- SPOT. TB testing for tuberculous pleurisy is of high diagnostic value.2. ADA threshold to take 20.5 U/L the sensitivity is higher than the ADA threshold from 45U/L sensitivity.