Clinical Value Of T-SPOT.TB In The Diagnosis Of Tuberculous Pleural Effusion

Objective:In this study,the activity of T-SPOT.TB and adenosine deaminase(ADA)in pleural effusion patients with tuberculosis infection in peripheral blood were measured.Comparing the experimental results and the joint diagnosis results.To explore the value of T-SPOT.TB test in tuberculous pleural effusion.Methods:82 pleural effusion patients of unknown origin cause since September 2016 to December 2017 from the First Affiliated Hospital of Wannan Medical College yijishan hospital were enrolled in the study.The basic information of the patients was recorded,and the patients were examined according to their clinical symptoms and imaging findings.The sputum smears found acid-fast bacilli,culture of tuberculous bacteria,histopathological examination and response to antituberculous therapy,according to the final diagnosis and follow-up,get rid of 3 pepole who are gaven indeterminate results,finished 79 cases.Finally,79 patients were included in the study.The patients were included into the tuberculous pleural effusion group 64 cases(among them 1 case of sputum smear-positive,15 case of pathological diagnosis)and the non-tuberculous pleural effusion group(15 cases).Blood T-SPOT.TB and adenylate deaminase(ADA)in pleural effusion were detected.The sensitivity,specificity,negative predictive value(NPV),positive predictive value(PPV)were analyzed according to the final test results.Negative likelihood ratio and positive likelihood ratio were compared.Results:There were 82 cases of pleural effusion were admitted to the study except for 3cases whose results were uncertain.Among them 64 cases were diagnosed as tuberculous pleural effusion and 15 cases were diagnosed as non-tuberculous pleural effusion.In 64 patients with tuberculous pleural effusion,the number of patients with T-SPOT.TBand ADA positive in pleural effusion were 54 cases and 51 cases,respectively,the number of patients with T-SPOT.TB and ADA positive in peripheral blood of non-tuberculous pleural effusion were 9 cases and 3 cases,respectively.The sensitivity of T-SPOT.TB test in peripheral blood and ADA detection in pleural effusion to diagnosis of tuberculous pleural effusion were 85.71% and 94.44%,the specificity was 37.5% and 48.0%,positive predictive values were 84% and80%,negative predictive values were 40% and 80%,positive likelihood ratio was 1.37 and 1.82,negative likelihood ratio is 0.38 and 0.12,The sensitivity,specificity,positive predictive value,negative predictive value of three tests were disposed of X2 est and chi square values were 0.130(P=0.719)?0.1732(P=0.677)?0.0471(P=0.828)?1.2698(P=0.260).There was no statistical difference between T-SPOT.TB test in peripheral blood and ADA in pleural effusion.Conclusion:Determination of T-SPOT.TB in peripheral blood of patients is helpful in the diagnosis of tuberculous pleural effusion,T-spot and ADA in pleural effusion are similar in the diagnosis of tuberculous pleural effusion.The combined detection of T-spot and ADA is more important in the diagnosis of tuberculous pleural effusion.