Abstract: Objective  To evaluate the diagnostic value of T-SPOT.TB for the elderly pulmonary tuberculosis. Methods  From November 2010 to February 2012, 257 elderly inpatients (73 pulmonary TB patients with confirmed laboratory tests, 95 TB patients with clinical diagnosis, and 89 non-pulmonary tuberculosis patients) of the No.2 Department of Tuberculosis, The Third People’s Hospital of Kunming were recruited. The data were analyzed by SPSS 13.0. The sensitivity and specificity of T-SPOT.TB were compared with routine laboratory test such as acid-fast bacilli (AFB) smear and culture, skin test (PPD), TB-DOT/TB-CK, PCR for tuberculosis bacilli DNA (TB-DNA), and erythrocyte sedimentation rate (ESR). P<0.05 was considered statistically significant. Results  The sensitivities of T-SPOT.TB, PPD, TB-DOT/TB-CK, TB-DNA and ESR were respectively 87.7% (64/73), 57.4%(31/54), 71.4%(50/70), 77.6%(52/67) and 81.7%(58/71) for the TB patients with laboratory confirmation. The sensitivity of T-SPOT.TB was significantly higher than those of PPD and TB-DOT/TB-CK and the difference was statistically significant (χ²=5.831, P<0.05; χ²=15.083, P<0.01). The sensitivities of T-SPOT.TB, PPD, TB-DOT/TB-CK and ESR were respectively 86.3%(82/95), 57.3%(47/82), 42.4%(39/92) and 60.9%(56/92) for the patients with clinical TB diagnosis. The sensitivity of T-SPOT.TB was significantly higher than those of other laboratory tests (χ²=39.485, 18.726 and 15.650, P<0.01). The specificities of T-SPOT.TB, PPD, TB-DOT/TB-CK, TB-DNA and ESR were 92.1%(82/89), 82.7%(62/75), 83.1%(74/89), 98.9%(88/89) and 41.2%(35/85) respectively. The specificities of T-SPOT.TB was significantly higher than those of TB-DNA and ESR (χ²=4.712 and 51.254, P<0.05).  Conclusion The T-SPOT.TB has higher sensiti-vity and specificity in the diagnosis of elderly pulmonary tuberculosis, and it deserves the clinical expansion.

Key words: Tuberculosis, pulmonary/diagnosis, Interferon-gamma release tests, Aged