Diagnostic Value of TB-IGRA, PPD, TB-DNA-PCR and ADA in Tuberculous Pleural Effusion

摘要

Objective: To investigate the clinical diagnostic value of TB-IGRA (Tuberculosis-Interferon Gamma Release Assay), PPD (Intradermal Tuberculin Te>> style="font-family:;" "="">> style="font-family:Verdana;">st), TB-DNA-PCR (Tuberculosis-Deoxyribonucleic-Polymerase Chain Reaction) and ADA(Adenosine Aeaminase) in tuberculous pleural effusion. style="font-family:Verdana;">Methods:> style="font-family:Verdana;"> 60 patients with tuberculous pleural effusion discharged from our department from January 1, 2018 to December 31, 2019 were selected. Moreover, the TB-IGRA in peripheral blood, PPD test, TB-DNA-PCR and ADA in pleural effusion were detected. Subsequently, the positive rate, negative rate, sensitivity and omission diagnostic rate of style="font-family:Verdana;">TB-IGRA, PPD, TB-DNA-PCR, ADA and combined style="font-family:Verdana;">TB-IGRA were calculated.  style="font-family:Verdana;">Results: style="font-family:Verdana;"> style="font-family:Verdana;"> The positive rate and sensitivi> style="font-family:Verdana;">ty style="font-family:Verdana;"> of> style="font-family:Verdana;">TB-IGRA, PPD style="font-family:Verdana;">, style="font-family:Verdana;">TB-DNA-PCR, and ADA were 95%, 71.67%,>> style="font-family:;" "=""> style="font-family:Verdana;"> style="font-family:Verdana;"> style="font-family:Verdana;">5% and>> style="font-family:;" "=""> style="font-family:Verdana;"> 86.67% respectively. The omission diagnostic rate was 5%, 28.33%, 95% and style="font-family:Verdana;">13.33%. TB-IGRA showed the highest positive rate and sensitivity, and TB style="font-family:Verdana;">-DNA-PCR represented the highest omission diagnostic rate. The sensitivity of TB-IGRA + PPD was 98.33%, while the omission diagnostic rate was 51.67%. The sensitivity of TB-IGRA + TB-DNA-PCR was 95%, while the omission diagnostic rate was 5%. The sensitivity of TB-IGRA + ADA was 100%, while the style="font-family:Verdana;">omission diagnostic rate was 0%. In addition, the TB-IGRA + ADA had the style="font-family:Verdana;"> highest sensitivity and the lowest omission diagnostic rate. style="font-family:Verdana;"> style="font-family:Verdana;">Conclusion: style="font-family:Verdana;">> style="font-family:Verdana;">TB-IGRA has high positive rate, high sensitivity and low omission diagnostic rate, which is superior to the traditional sputum test for tuberculosis. Notably, the combination of PPD, TB-DNA-PCR, ADA is capable of improving the diagno style="font-family:Verdana;">sis rate, and the diagnosis rate can reach 100% when combined with ADA, style="font-family:Verdana;"> which is able to provide solid diagnostic value in clinical practice.