The Diagnostic Efficiency Of Combination TB-IGRA (Tuberculosis Interferon-Gama Release Assay) With HLA-G (Human Leukocyte Antigen-G) For Tuberculosis

ObjectiveTo study the expression of IFN-y by tuberculosis specific T cells(TB-IGRA)and HLA-G(Human Leukocyte Antigen-G)in the peripheral blood of tuberculosis patients and its diagnostic value in tuberculosis.MethodsThis was a retrospective cohort study.Study cases were all from Resparation Department of Shaoxing Municipal Hospital from January 2015 to December 2015.These patients were devided into tuberculosis group(TB)(34 cases),lung cancer group(LCa)(25cases)and non tuberculous pneumonia group(Non-TB pneumonia)(25cases)according to diagnosis,meanwhile,health group(35cases)was set.IFN-y and sHLA-G were detected by ELISA,and mHLA-G was detected by Flowcytometre,T lymphocytes subsets were detected by Flowcytometre too.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of TB-IGRA,sHLA-G and mHLA-GResults1.The expression ofsHLA-G(median of 99.44 U/ml,P25～P75 87.41～172.7 U/ml)and mHLA-G(median of 13.63%,P25～P75 11.54%～15.35%)were higher in the TB group than in the LCa group(median of82.3 U/ml,P25～P75 59.11～132.77 U/ml and median of9.12%,P25～P75 8.67%～14.34%),Non-TB pneumonia group(median of 34.2 U/ml,P25～P75 24.45～61.23 U/ml and median of 10.92%,P25～P75 6.96%～12.88%)and health group(median of 31.28 U/ml,P25～P75 25.85～42.61 U/ml and median of 8.18%,P25～P75 6.56%～10.05%)(p<0.05)2.The expression of IFN-yof TB-IGRA were higher in the TB group(median of 182.5 ng/L,P25～P75 167.7～277.3 ng/L)than in the LCa group(median of 117.0ng/L,P25～P75 82.9～133.5 ng/L),Non-TB pneumonia group(median of 80.84 ng/L,P25～P75 61.1～100.6 ng/L)and health group(median of 30.5 ng/L,P25～P75 22.0～39.1 ng/L)(p<0.05).3.The AUC-ROC of TB-IGRA,sHLA-G and mHLA-G were 0.842(95%CI,0.761-0.922),0.746(95%CI,0.652-0.840)and 0.706(95%CI,0.605-0.806).The sensitivity for TB-IGRA,sHLA-G and mHLA-G was 88.24%,70.59%and 67.65%,and the specificity was 60%,72.94%and 70.59%at the cutoff value of 35ng/L,60U/mL and 10%respectively.The sensitivity and specificity of combination detection for TB-IGRA and HLA-G were 88.24%and 81.18%.Conclusions1.sHLA-G and mHLA-G increased in the Peripheral blood of TB patients,and Percentage of activated T cells and regulatory T cells increased in TB patients2.The expression of IFN-γ of TB-IGRA increased in TB patients,sHLA-G mHLA-G and TB-IGRA can be used in TB diagnosis,while quantitative detection of TB-IGRA is more helpful.3.The combination detection of TB-IGRA,sHLA-G and mHLA-G can improve the sensitivity in the diagnosis of tuberculosis which is helpful in clinic.