The value of enzyme-linked immunospot assay test in the diagnosis and evaluation of curative effect of tuberculous pleurisy

Wang Lihong, Fu Xiuhua, Zhang Guizhi, Li Guohua, Gu Yan, Gao Junzhen
unpublished
Objective: To investigate the value of enzyme-linked immunospot assay test (ELISPOT) (T-SPOT.TB) in the diagnosis and therapeutic effect of tuberculous pleurisy. Methods: Collected 93 cases of Affiliated Hospital of Inner Mongolia Medical University patients with pleural effusion. The peripheral blood and pleural effusion of the patients with non hemorrhagic exudative pleural effusion were tested by T-SPOT.TB before treatment. The peripheral blood of the patients of clinically diagnosed as
more » ... y diagnosed as tuberculous pleurisy were tested by T-SPOT.TB again after 3 months regular anti tuberculosis. Result: There are 63 cases in 93 patients with pleural effusion were diagnosed as tuberculous pleurisy. Among them, the positive rate of T-SPOT.TB test in peripheral blood and pleural effusion was 90.48%(57/ 63) and 100%(63/63) respectively. There are 30 cases were diagnosed as non tuberculous pleurisy. Among them, the negative rate of T-SPOT.TB test in peripheral blood and pleural effusion was 83.33%(25/30) and 70%(21/30). In our study, the negative predictive value(Specificity) and the positive predictive value of T-SPOT.TB test in peripheral blood was 80.65%(25/31) and 91.94%(57/62). The negative predictive value and the positive predictive value of T-SPOT.TB test in pleural effusion was 100%(21/21) and 87.5%(63/72). The average numbers of spot forming cells(SFCs) in Pleural effusion were 4.69 times that in peripheral blood. The numbers of SFCs in peripheral blood were obviously decreased or loss after 3 months anti tuberculosis therapy. Conclusion: T-SPOT TB is a sensitive and specific test in the diagnosis of tuberculous pleurisy, especialy in pleural effusion. T-SPOT TB can be used as evaluation index of tuberculosis treatment. 
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