Diagnostic Value Of T-SPOT.TB In Patients With Immunocompromised Pulmonary Tuberculosis

Objective: patients with diabetes mellitus(DM),rheumatic disease(RDV),lung cancer(LCa)and other immunocompromised patients are high risk groups for pulmonary tuberculosis.Through this study,we can provide relevant diagnostic basis for clinical atypical patients,such as hypoimmune pulmonary tuberculosis and so on,in order to provide a new method of assistant detection in clinic.In order to make early accurate diagnosis and timely and effective treatment for such patients.Methods: a total of 889 inpatients were collected from the affiliated Yijishan Hospital of Wannan Medical College.There were 305 cases of pulmonary tuberculosis(TB)group,156 cases of control group,106 cases of diabetes mellitus(DM)group,240 cases of rheumatic disease(RD)group,82 cases of lung cancer(LCa)group,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),tuberculin skin test(TST),chest CT and T-SPOT.TB were examined.Results:1.In active pulmonary tuberculosis patients,the sensitivity of T-SPOT.TB and TST were 84.9% and 72.8%,the specificity were 89.7% and 79.5% respectively.The positive predictive values of T-SPO T.TB and TST were 94.2% and 87.4%,and the negative predictive values were 75.3% and 59.9%,respectively.2.In diabetes complicated with pulmonary tuberculosis patients,the sensitivity of T-SPOT.TB and TST were 79.4% and 58.8%,the specificity were 81.6% and 68.4% respectively.The positive predictive values of T-SPO T.TB and TST were 88.5% and 76.9%,respectively,and the negative predictive values were 68.8% and 48.1%,respectively.3.In rheumatic diseases complicated with pulmonary tuberculosis patients,the sensitivity of T-SPO T.TB and TST were 90.0% and 57.5%,the specificity were 93.0% and 85.5% respectively.The positive predictive values of T-SPO T.TB and TST were 72.0% and 44.2%,and the negative predictive values were 97.9% and 91.0%,respectively.4.In lung cancer complicated with pulmonary tuberculosis patients,the sensitivity of T-SPO T.TB and TST were 85.7% and 64.3%,the specificity were 88.2% and 69.1% respectively.The positive predictive values of T-SPO T.TB and TST were 60.0% and 30.0%.The negative predictive values were 96.8% and 90.4%,respectively.Conclusion: 1.The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in the diagnosis of pulmonary tuberculosis are better than that of TST.The T-SPOT.TB can be used as an important assistant method in the diagnosis of pulmonary tuberculosis.2.The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in diagnosing diabetes complicated with pulmonary tuberculosis infection is better than TST,which can be used as an important detection method in patients with diabetes mellitus complicated with pulmonary tuberculosis.3.The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in the diagnosis of rheumatic diseases complicated with pulmonary tuberculosis infection are better than those of TST.The T-SPOT.TB can be used as an important detection method in patients with rheumatic diseases complicated with pulmonary tuberculosis.4.The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in the diagnosis of lung cancer complicated with pulmonary tuberculosis infection were better than that of TST.The T-SPOT.TB can be used as an important method for detection of lung cancer complicated with pulmonary tuberculosis.5.The sensitivity of T-SPOT.TB in the diagnosis of diabetic patients with pulmonary tuberculosis infection is lower than that in patients with pulmonary tuberculosis.6.T-SPO T.TB does not affect sensitivity in the diagnosis of rheumatic diseases with pulmonary tuberculosis and lung cancer with pulmonary tuberculosis.