The application value of T-SPOT.TB in patients with malignant tumor complicated with tuberculosis

doi:10.3969/j.issn.1000-6621.2018.04.003

Abstract

Abstract:

Objective To analyze the clinical application value of T-SPOT.TB in detecting malignant tumor complicated with tuberculosis. Methods From January to December 2016, 102 patients with malignant tumor complicated with tuberculosis, 64 with malignant tumor, and 80 with tuberculosis were selected from Xi’an Chest Hospital. Peripheral blood mononuclear cells (PBMC) were isolated from the peripheral blood of each patient, and the performances of T-SPOT.TB in detecting different patient populations were analyzed. At the same time, the sensitivity and specificity of T-SPOT.TB in detection of malignant tumor complicated with tuberculosis were tested, as well as the consistency with acid-fast staining and/or pathological examination. Results The positive rate of T-SPOT.TB in detecting malignant tumor complicated with tuberculosis was 85.29% (87/102), and the positive rate in detecting malignant tumor was 26.56% (17/64); the difference was statistically significant (χ ²=57.97, P<0.01). The positive rate in detecting tuberculosis was 91.25% (73/80), and there was no statistical significance compared with that of malignant tumor complicated with tuberculosis (χ ²=1.50, P=0.221). Furthermore, the positive spot numbers of A and B antigen in different patient were also compared. For the patients with malignant tumor complicated with tuberculosis and those with tuberculosis only, the median (Q₁, Q₃) positive spot number of A antigen was 56.50 (30.25, 83.25) and 45.50 (32.00, 75.00), and that of B antigen was 63.50 (43.25, 98.00) and 55.00 (24.00, 101.50), respectively. The differences between the two patient populations had no statistical significance (Z=-0.66 and -0.30, P=0.539 and 0.796, respectively). The sensitivity and specificity of T-SPOT.TB for malignant tumor complicated with tuberculosis were 85.29% (87/102) and 73.44% (47/64), respectively. Compared with acid fast staining and/or pathological examination, the Kappa value of T-SPOT.TB was 0.61. Conclusion T-SPOT.TB has good detection efficiency for patients with malignant tumor complicated with tuberculosis, which can be used for auxiliary diagnosis.

Key words: Enzyme-linked immunospot assay, Neoplasms, Tuberculosis, Comorbidity, Evaluation studies

Juan-wen LIAN,Li-yun DANG,Jia-ling XU,Yu FAN. The application value of T-SPOT.TB in patients with malignant tumor complicated with tuberculosis[J]. Chinese Journal of Antituberculosis, 2018, 40(4): 353-357. doi: 10.3969/j.issn.1000-6621.2018.04.003

Figures/Tables 3

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检测指标	恶性肿瘤并发结核病(102例)	恶性肿瘤(64例)	χ²值	P值
A抗原阳性	11(10.78)	2(3.12)	3.20	0.074
B抗原阳性	5(4.90)	2(3.12)	0.31	0.597
A、B抗原均阳性	71(69.61)	13(20.31)	38.23	<0.01
合计	87(85.29)	17(26.56)	57.97	<0.01

检测指标	恶性肿瘤并发结核病组(102例)	单纯结核病组(80例)	χ²值	P值
A抗原阳性	11(10.78)	6(7.50)	0.57	0.450
B抗原阳性	5(4.90)	4(5.00)	0.03	0.873
A、B抗原均阳性	71(69.61)	63(78.75)	1.93	0.165
合计	87(85.29)	73(91.25)	1.50	0.221

检测方法	恶性肿瘤并发结核病组(102例) 阳性例数	恶性肿瘤组 (64例) 阴性例数	敏感度 (%)	特异度 (%)	Kappa值	P值
抗酸染色和(或)病理检查	76	64	74.51	100.00
T-SPOT.TB检测	87	47	85.29	73.44	0.610	<0.01
PPD试验	42	44	41.18	68.75	0.063	0.52
结核抗体检测	58	38	56.86	59.38	0.195	0.097