Diagnostic efficiency of ADA and LDH in pleural effusion and T-SPOT.TB in peripheral blood for tuberculous pleurisy

Objective To investigate the efficiency of peripheral blood tuberculosis infection T cell spot test (T-SPOT.TB), adenosine deaminase (ADA)and lactate dehydrogenase (LDH) activity of pleural effusion for tuberculous pleurisy.

Methods The receiver operating characteristic (ROC) curve was used to analyze the examination results of ADA and LDH of pleural effusion and T-SPOT.TB in peripheral blood in both 40 patients with tuberculous pleurisy and 48 patients with non-tuberculous pleurisy.

Results The positive rates of ADA, LDH, TSPOT.TB and three combined tests in patients with non-tuberculous pleurisy were significantly lower than those of patients with tuberculous pleurisy (P < 0.01). Among patients with tuberculous pleurisy, the positive rate of combined three indicators was the highest (95.0%). The positive rates of these indicators among patients with non-tuberculous pleurisy varied statistically (P < 0.01), and only 1 patient (2.0%) had positive rate for all combined 3 indicators. The medians of LDH and ADA levels in pleural effusion of patients with tuberculous pleurisy were higher than those in the patients with non-tuberculous pleurisy(P < 0.01). The area of ADA under the ROC curve was equal to that of T-SPOT.TB, and was larger than that of LDH; the ROC curve of T-SPOT.TB was the closest to the top left. For diagnosis of tuberculous pleural effusion, the order of specificity was T-SPOT. TB > ADA > LDH, and the order of sensitivity was ADA > TSPOT.TB > LDH.

Conclusion T-SPOT.TB, ADA and LDH test had important clinical value in the rapid diagnosis of tuberculous pleurisy, and the clinical value of T-SPOT.TB was the best.