Study On The Value Of T-SPOT.TB Test In Tuberculous Pleurisy

Background and ObjectiveTuberculous pleurisy is one of the most common forms of extra pulmonarytuberculosis.The common cause of the effusion is a delayed hypersensitivity response tomycobacterial antigens in the pleural space. For this reason, it is difficult to find tuberclebacillus in pleural effusion smear,also difflcult to get positive culture from pleural effusion.With the development of modern technology in medical testing in recent years, thet-spot.tb test (T-SPOT.TB) based on measuring interferon-r release by sensitized T cellsfrom peripheral blood or pleural fluid in response to highly M. tuberculosis-specificantigens plays a great important role in the diagnosis of tuberculosis. We explore the valueof T-SPOT.TB test in diagnosis of tuberculous pleurisy by comparing the T-SPOT.TB testand adenosine deaminase (ADA) of hydrothorax, tuberculosis antibody（TB-Ab）.MethodsWe analyzed the results of the T-SPOT.TB, pleural effusion adenosine deaminase(ADA),and tuberculosis antibody (TB-Ab) of62patients diagnosed as exudative pleuraleffusion who were admitted to the No.5People’s Hospital of Wuxi from September2012to June2013. These Patients were divided into two groups: TB group which consists of32cases and control group which consists of30cases..According to the final diagnosis, thesensitivity,specificity of T-SPOT.TB were analyzed.Results:The sensitivity of T-SPOT.TB, ADA, TB-Ab were90.6%,71.9%,62.5%respectively.The specificity of T-SPOT.TB, ADA, TB-Ab were90.0%,83.3%,86.7%respectively. Thesensitivity of T-SPOT.TB was the highest one among the three methods. The positive rateof T-SPOT.TB was a statistically significant difference compared with TB-Ab(P <0.05),but no statistically significant difference compared with ADA (P>0.05).Conclusion:1. The T-SPOT.TB test had higher sensitivity and specificity for the diagnosis of tuberculous pleurisy, and had important reference value in early, rapid and accuratediagnosis of patients with tuberculous pleurisy.2. The positive rate of T-SPOT.TB had a statistically significant difference comparedwith TB-Ab, but no statistically significant difference compared with ADA in diagnosis ofpatients with tuberculous pleurisy. The T-SPOT.TB and TB-Ab combination examinationhad a complementary effect.