Risk Factors For False-negative Results Of T-SPOT.TB Assay In Patients With Tuberculous Pleurisy

Objective:In order to improve the diagnostic value of T-SPOT.TB test in tuberculous pleurisy,the possible risk factors affecting false negative of T-SPOT.TB were screened and analyzed in specific patients with tuberculous pleurisy.Methods:We analyzed 239 patients with diagnosis of TBP during the period of January,2014 to June,2015.According to the results of T-SPOT.TB,patients were divided into false negative group and positive group.Univariate and multivariable analysis were used to evaluate the risk factors for false-negative of T-SPOT.TB results in patients with TBP.Results:In our research,206 patients(86.2%)had true-positive and 33 patients(16.0%)had false-negative T-SPOT.TB results.Multivariate analysis showed that increased age[middle-aged subgroup(40-59 years)OR=7.203,95%Cl(2.056-25.237),p=0.002;elderly subgroup(?60 age),OR=6.412,95%Cl(1.794-22.914),p=0.004],Pleural puncture before T-SPOT.TB[OR=2.527,95%CI(1.036-6.165),p=0.042],extra-pulmonary tuberculosis[OR 3.786,95%CI(l.273-11.262),p=0.017],During anti-TB treatment[OR4.650,95%CI(1.288-16.783),p=0.019]were independent risk factors for false-negative results of T-SPOT.TB in TBP patients.While lymphocyte counts[OR 0.324,95%CI(0.105-0.999),p=0.050]was independent protective factor for false?negative results of T-SPOT.TB in TBP patients.Conclusion:In clinical work,we need takemore serious consideration about T-SPOT.TB negative results in TBP patients,especially in aged peoples,lymphocytopenia patients,coexistence with extra-pulmonary tuberculosis of other parts or receiving anti-tuberculosis treatment.