A Comparative Study on Four Methods in the Diagnosis of Tuberculosis / 现代检验医学杂志

ABSTRACT

Objective To evaluate the value of four methods in diagnosis of pulmonary tuberculosis,including T-SPOT,fluo-rescent PCR,anti-TB antibody test,and acid-fast staining.Methods Retrospective analysis of 530 cases between January 2012 and December 2014 who had taken four methods,and calculated the sensitivity specificity,positive predictive value,neg-ative predictive value,Kappa value,Youden index,positive likelihood ratio,negative likelihood ratio,Pairedχ2 test.Consider clinical diagnosis as the gold standard.Results The sensitivity,negative predictive value,Youden index of T-SPOT were 95.90%,97.29%,0.82,respectively,and all of these were the highest.The negative likelihood ratio of T-SPOT was 0.05, which was the lowest.Misdiagnosis rate of PCR was 87.18%,which was the highest.Positive likelihood of anti-TB antibody test was the lowest,6.48,while other indicators were no advantage.The specificity,positive predictive value and positive likelihood ratio of acid-fast staining were 99.70%,98.90%,153.83,respectively,and the three of these were highest.Pair-wise comparison between the four methods were significantly different.Conclusion The T-SPOT and acid-fast staining can be used as important methods,and the anti-TB antibody can provide result quickly,and PCR method is more suitable for ex-amination of sterile body fluids.