The Diagnostic Value Of The Combined Detection Of T-SPOT.TB, ADA And TB-DNA In Tuberculous Pleurisy Effusion

Objective: To evaluate the diagnostic value of T-SPOT.TB,deaminase(ADA)and mycobacterium tuberculosis deoxyribonucleic acid(TB-DNA)alone and in combination in tuberculosis pleurisy.Methods: Patients with pleural effusion admitted to the respiratory department of Shanghai General Hospital from August 2015 to Decemder 2018 were collected.Data of patients who were checked for T-SPOT.TB,pleural effusion ADA and pleural effusion TB-DNA after admission were retrospectively analyzed.Results :1.The positive rate(T-SPOT.TB :83.56%,ADA:78.08%,TB-DNA:20.55%)of tuberculous pleural effusion patients was significantly higher than that in non-tuberculous pleural effusion group(T-SPOT.TB :17.39%,ADA:24.64%,TB-DNA:4.35%),and the differences were statistically significant(p<0.05).2.The sensitivity and specificity of T-SPOT.TB,pleural effusion ADA,and TB-DNA detection methods for tuberculous pleural effusion were(83.56%,78.08%,20.55%)and(82.61%,75.36%,95.65%),respectively.3.In parallel joint detection,the sensitivity of T-SPOT.TB or ADA or TB-DNA diagnosis was the highest(98.63%).the specificity of T-SPOT.TB or TB-DNA was the highest(81.16%)in the diagnosis of tuberculous pleural effusion.4.In serial joint detection,the specificity of joint diagnosis of tuberculous pleural effusion was between 94.2%-100%,the specificity of T-SPOT.TB and ADA and TB-DNA,ADA and TB-DNA were both 100%.The sensitivity of joint detection diagnosis was between 13.7% and 65.75%.Conclusion:1.Parallel joint detections can significantly improve the sensitivity of the diagnosis of tuberculous pleurisy and reduce the rate of missed diagnosis,among which T-SPOT.TB or ADA or TB-DNA has the highest sensitivity.2.serial joint detections can improve the specificity of diagnosis of tuberculous pleurisy and reduce the misdiagnosis rate,and in which the specificity of the combination of T-SPOT.TB and ADA and TB-DNA and the combination of ADA and TB-DNA were 100%.3.TB-DNA has great specificity value in the diagnosis of tuberculous pleurisy,but little value in the sensitivity.