Application Value Of Detection Of IFN-γ And IP-10Level Simultaneously In Tuberculous Pleural Effusion

Object i ve Tuberculous and malignant pleural effusion is the most common exudative pleural effusion in clinical, of which treatment and prognosis are very different, so the correct identification is very important. Looking for a suitable, non-invasive, high sensitivity, high specificity and high accuracy detection indicators is essential for getting early and accurate diagnosis. IFN-y and IP-10is now recognized as the indicator of differential diagnosis of tuberculous pleural effusion and malignant pleural effusion. The determination of IFN-y is mainly through IGRAs, such as the British company Oxford Immunotec’s T-SPOT.TB kit, which detected the numbers of T lymphocytes infected by tuberculosis and stimulated by ESAT-6and CFP-10. The kit has a higher sensitivity and specificity compared with the conventional tuberculin skin test which is not affected by non-tuberculous mycobacterium and BCG, while it has expensive cost, complex operation and cumbersome steps. The liquid-chip technology used in this study is a multi-function system of parallel analysis of multiple indicators, which synthesizes technologies of encoding microspheres, laser, flow cytometry, digital signal processing technology, so it is high-throughput, high efficiency, high degree of automation, simple operation, accurate and save time. Now, this study was to investigate the diagnostic value of joint detection of IFN-γ and IP-10through liquid chip technology to verify the clinical applications values and advantages and disadvantages by contrast with the classic T-SPOT.TB methods simultaneously.Methods The subjects of exudative pleural effusions are90cases totally, including52tuberculous pleural effusions and38other pleural effusions. Pleural effusion of50ml extracted before regular treatment is measured the number of T cells infected with tuberculosis by T-TSPOT.TB, while measured the level of IFN-γ and IP-10by liquid chip technology, and then, a joint diagnostic factor P of combined detection of IFN-γ and IP-10is calculated by Binary Logistic regression which is served as a new parameter to compare clinical diagnostic value with T-SPOT.TB.Result The sensitivity of the four diagnostic methods of T-SPOT.TB, IFN-γ, IP-10and combined detection were90.38%,90.38%,94.23%,98.08%respectively, the specificity were84.21%,92.11%,94.74%,97.37%respectively, the positive likelihood ratio was5.72,11.45,17.90,37.27respectively, the negative likelihood ratios were0.11,0.10,0.061,0.020respectively. Area under the ROC curve was0.938,0.965,0.962,0.995respectively. The difference of positive rate between joint detection method and T-SPOT.TB was not statistically significant (P>0.05), while the diagnostic consistency is good (KAPPA=0.703). In addition, the discrepancy of both AUC is statistically significance (P=0.0459<0.05), and the diagnostic value of combined detection of IFN-y and IP-10is better.Conclusion The IFN-y and IP-10levels of TB group were significantly higher than the control group and the difference was statistically significant. The combined detection of IFN-y and IP-10through liquid chip technology to diagnosing of tuberculous pleural effusion is worthy recommended for clinical application, for its highly accuracy, simple operation and save time.