The diagnostic value of T-SPOT.TB and ADA for tuberculous pleurisy / 国际检验医学杂志

ABSTRACT

Objective To evaluate the diagnostic value of peripheral blood T-SPOT.TB and pleural effusion′s adenosine deami-nase(ADA)activity in patients with tuberculous pleurisy.Methods Sixty-two patients with suspected tuberculous pleurisy were enrolled in the study,whose peripheral blood T-SPOT.TB and pleural effusion ADA were measured and the best diagnostic thresh-old was determined by ROC curve.Results According to the diagnostic criteria of tuberculous pleurisy,24 patients were diagnosed with tuberculous pleurisy,33 were non-tuberculous pleurisy and 5 undiagnosed in the end.The sensitivity of T-SPOT.TB for the diagnosis of tuberculous pleurisy was 91.7 %,the specificity was 81.8%,Positive predictive value was 78.6%,negative predictive value was 93.1%.The ADA activity was (40.5±15.4)IU/L in tuberculous pleurisy group,which was higher than in non tubercu-lous pleurisy group[(2.4 ±9.5 )IU/L](P <0.01 ).The cut-off value of ADA was 22.5 IU/L in tuberculous pleurisy diagnosis, while its sensitivity and specificity were 83.3% and 84.8% respectively.The sensitivity of the combined detection of T-SPOT.TB and ADA was 95.8%.Conclusion The combined detection of peripheral blood T-SPOT.TB and pleural effusion ADA has a higher sensi-tivity in diagnosis of tuberculous pleurisy,and has important auxiliary diagnostic value for patients with suspected tuberculous pleurisy.