Objective To evaluate the diagnostic value of
interferon-γ release assay of
blood and
pleural effusion for
tuberculous pleurisy.
Methods Fifty-six
adult patients with suspected
tuberculous pleurisy were enrolled in our study.The
blood and
pleural effusion interferon-γ release assay were measured by T-SPOT.TB test in 38
pleural tuberculosis patients and 18 nontuberculous
pleurisy controls.The diagnostic
sensitivity,
specificity,predictive value of T-SPOT.TB in
pleural effusion mononuclear
cells (PE-MC) and peripheral mononuclear
cells (PBMC) were analyzed.Results The sensitivities and specificities,
positive predictive values and
negative predictive values,respectively,of the PE-MC and PBMC for diagnosing were as follows86.5%(95%
confidence interval[CI] 71.2%-95.5%) and 100%(95%CI 90.5%-100%);52.9%(95%CI 27.8%-77.0%) and 35.3%(95%CI 14.2%-61.7%);80.0%(95%CI 64.4%-90.9%) and 77.1%(95%CI 62.7%-88.0%);64.3%(95%CI 35.1%-87.2%) and 100%(95%CI 54.1%-100%).By
ROC curve analysis,a cut-off value of 47SFC/2.5 × 105
cells in PE-MC showed a
sensitivity of 89.2% and a
specificity of 88.2%.Conclusion T-SPOT.TB in PE-MC could be an accurate diagnostic
method for
tuberculous pleurisy in TB endemic settings.Moreover,47SFC/2.5 × 105
cells might be the optimal cut-off value for diagnosing
tuberculous pleurisy.