Clinical Value Of Enzyme-linked Immunospot Test In The Diagnosis Of Pulmonary Tuberculosis

Objective:To investigate the clinical value of the enzyme-linked immunospot test(T-SPOT.TB) in the diagnosis of pulmonary tuberculosis(PTB)patients. Methods:172 cases of patients with respiratory from December 2013 to December 2014 in the first affiliated hospital of xinjiang medical university were retrospectively analyzed,and were divided into the group of tuberculosis(including18 confirmed group cases and 78 clinical diagnosis group cases), pneumonia group according to the diagnostic standard.The two groups separately complete T-SPOT.TB test, TB-DNA, TB-Ab, chest CT, and Sputum smear microscopy. The diagnostic value of the test was analyzed. Results:Among 96 pulmonary tuberculosis patients,92 cases was positive result,and the sensitivity was 95.83%. Among 76 pneumonia patients, 67 cases was negative result,the specificity was 88.16%, positive likelihood ratio was 7.44, the negative likelihood ratio was 0.05, the positive predictive value was 91.09%, the negative predictive value was 94.37%, Youden index was 0.84, and Kappavalue was 0.85. The difference of T-SPOT.TB between tuberculosis and pneumonia group was significant(P<0.05). Positive rate of confirmed group and clinicaldiagnosis group were 94.44%, 96.15% respectively, and the difference between the two groups had no statistical significance(P>0.05). The sensitivity of the T-SPOT.TB test was superior to that of TB-DNA(28.00%), TB-Ab(16.22%), sputum smear microscopy(18.31%), chest CT(53.13%)(P<0.01). The specificity of the test was better than that of chest CT(P<0.01). The T-SPOT.TB test Comparing with TB-DNA(95.24%), and TB-Ab(92.59%), it had no statistical significance(P>0.05). Conclusion:T-SPOT.TB has a good sensitivity and specificity for the diagnosis of pulmonary tuberculosis(PTB)patients.