The Diagnostic Value Of The T-SPOT.TB,Medical Thoracoscopy And TB-qPCR In Tuberculous Pleural Effusion

Objective:The value of three examinations in the diagnosis of tuberculous pleural effusion was analyzed by analyzing and comparing the venous blood T-SPOT.TB of the patients with tuberculous pleural effusion and non-tuberculous pleural effusion,the pathology of the pleural biopsy under medical thoracoscopy,and the pathological tissue TB-qPCR.Methods:The clinical date of patient with pleual effusion who received medical thoracoscopy from September 2015 to January 2018 in the Department of Respiratory Medicine of the First Affiliated Hospital of Kunming Medical University was analyzed retrospectively.According to the final diagnosis,it can be divided into tuberculous pleural effusion and non-tuberculous pleural effusion.Of those,44 patients had tuberculous pleural effusion,49 patients had non-tuberculous pleural effusion.For all patients with the venous blood T-SPOT.TB,the pathology of the pleural biopsy under medical thoracoscopy,and the pathological tissue TB-qPCR.To compare the venous blood T-SPOT.TB,the pathology of the pleural biopsy under medical thoracoscopy,the pathological tissue TB-qPCR three methods individually and combined for the value of specificity and sensitivity in the diagnosis of tuberculous pleural effusion?Results:(1)The sensitivity(81.81%)and specificity(91.83%)of the the pathology of the pleural biopsy under medical thoracoscopy diagnosis of tuberculous pleural effusion was the best;Followed by the venous blood T-SPOT.TB(sensitivity(79.54%)and specificity(69.38%));The sensitivity(43.18%)the pathological tissue TB-qPCR was poor,the specificity(93.87%)was high.(2)The the pathology of the pleural biopsy under medical thoracoscopy combine with the venous blood T-SPOT.TB diagnosis of tuberculous pleural effusion sensitivity and specificity was 88.36%,95.91%;The the pathology of the pleural biopsy under medical thoracoscopy combine with the the pathological tissue TB-qPCR diagnosis of tuberculous pleural effusion sensitivity and specificity was 90.90%,97.95%.The the pathology of the pleural biopsy under medical thoracoscopy combine with the the pathological tissue TB-qPCR?venous blood T-SPOT.TB diagnosis of tuberculous pleural effusion sensitivity and specificity was 95.45%,95.91%.Conclusion:The sensitivity and specificity of the the pathology of the pleural biopsy under medical thoracoscopy diagnosis of tuberculous pleural effusion was the best;For the untypical pathological tissue of the tuberculous pleural effusion,diagnosis combine with the pathology of the pleural biopsy under medical thoracoscopy?the pathological tissue TB-qPCR?venous blood T-SPOT.TB significantly improved theensitivity and specificity,reduced the risk of missed diagnosis and misdiagnosis,and is worthy of clinical promotion.