TITLE:
Diagnostic Value of TB-IGRA, PPD, TB-DNA-PCR and ADA in Tuberculous Pleural Effusion
AUTHORS:
Weijia Lin, Zhi Liu, Yaping Zhang, Yanan Yu, Yang Liu, Ping Feng, Feng Li, Zhihua Zhang
KEYWORDS:
TB-IGRA, PPD, TB-DNA-PCR, ADA, Diagnosis
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.9 No.3,
July
26,
2021
ABSTRACT: Objective: To investigate the clinical
diagnostic value of TB-IGRA (Tuberculosis-Interferon
Gamma Release Assay), PPD (Intradermal Tuberculin Test), TB-DNA-PCR (Tuberculosis-Deoxyribonucleic-Polymerase
Chain Reaction) and ADA(Adenosine Aeaminase) in tuberculous pleural effusion. Methods: 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 TB-IGRA, PPD,
TB-DNA-PCR, ADA and combined TB-IGRA were calculated. Results: The positive rate and sensitivity of TB-IGRA,
PPD,TB-DNA-PCR, and ADA were 95%, 71.67%, 5% and 86.67%
respectively. The omission diagnostic rate was 5%, 28.33%, 95% and 13.33%. TB-IGRA showed the highest positive rate
and sensitivity, and TB-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 omission diagnostic rate
was 0%. In addition, the TB-IGRA + ADA had the highest sensitivity and the lowest omission diagnostic rate. Conclusion: 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 diagnosis
rate, and the diagnosis rate can reach 100% when combined with ADA, which is able to provide solid diagnostic value
in clinical practice.