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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

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 ofAffiliated Hospital of InnerMongoliaMedical University patients with pleural effusion. The peripheral blood and pleural effusion of the patientswith non hemorrhagic exudative pleural effusion were tested by T-SPOT.TB before treatment. The peripheral blood of the patients of clinically diagnosed as tuberculous pleurisy were tested by T-SPOT.TB again after 3 months regular anti tuberculosis. Result: There are 63 cases in 93 patientswith 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.