Volume 42 Issue 9
Sep.  2021
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Zhe GE, Si-ping LU, Shi-zhong FU, Chun-hong WANG, Shao-ying LI, Ao LIU. The Preliminary Application of Whole Blood Interferon-Gamma Release Assay Combined with T Lymphocyte Subset Detection in Diagnosis of Pulmonary Tuberculosis[J]. Journal of Kunming Medical University, 2021, 42(9): 108-113. doi: 10.12259/j.issn.2095-610X.S20210901
Citation: Zhe GE, Si-ping LU, Shi-zhong FU, Chun-hong WANG, Shao-ying LI, Ao LIU. The Preliminary Application of Whole Blood Interferon-Gamma Release Assay Combined with T Lymphocyte Subset Detection in Diagnosis of Pulmonary Tuberculosis[J]. Journal of Kunming Medical University, 2021, 42(9): 108-113. doi: 10.12259/j.issn.2095-610X.S20210901

The Preliminary Application of Whole Blood Interferon-Gamma Release Assay Combined with T Lymphocyte Subset Detection in Diagnosis of Pulmonary Tuberculosis

doi: 10.12259/j.issn.2095-610X.S20210901
  • Received Date: 2021-07-15
    Available Online: 2021-09-09
  • Publish Date: 2021-09-30
  •   Objective   To evaluate the clinical application value of whole blood interferon-gamma release assay (IGRA) combined with T lymphocyte subset detection in diagnosis of pulmonary tuberculosis (TB).   Methods   A total of 58 consecutive patients diagnosed with pulmonary tuberculosis who were hospitalized in our hospital from September 2015 to February 2016 in our hospital were enrolled, including 41 patients with sputum-coated positive pulmonary tuberculosis or confirmed as the pulmonary tuberculosis by pulmonary fine needle aspiration biopsy, and 17 patients with sputum-coated negative and clinically diagnosed as the pulmonary tuberculosis by effective anti-tuberculosis treatment. 48 healthy volunteers were randomly selected in our hospital as the control group. All subjects underwent blood γ- interferon release assay, and T lymphocyte subsets test.   Results   The sensitivity of IGRA diagnosis of tuberculosis was 86.2% (50/58), the specificity was 95.8% (46/48), the underdiagnosis rate was 13.8% (8/58), and the misdiagnosis rate was 4.2% (2/48), and the area under the ROC curve (AUC) was 0.816 (P = 0.001). CD3+, CD4+ and CD4+/CD8+ were significantly decreased and CD8+ was significantly increased in the TB group at the baseline, and the differences were statistically significant compared with the control group (P < 0.05). The sensitivity of IGRA combined with T lymphocyte subsets detection for the diagnosis of tuberculosis was 96.6% (56/58), the specificity was 91.7% (44/48), the underdiagnosis rate was 3.4% (2/58) and the misdiagnosis rate was 8.3% (4/48). The AUC of IGRA test combined with T lymphocyte subsets detection was 0.911 (P < 0.001).   Conclusion   The IGRA combined with T lymphocyte subsets test has the high sensitivity and specificity in the diagnosis of the pulmonary tuberculosis, and the rate of missed diagnosis is significantly lower than that of single IGRA test, which has the high diagnostic value and is worthy of clinical promotion.
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