Significance of T-cell dot test and combined detection of adenosine deaminase in tuberculous pleurisy at different ages

Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages. Methods From February 2014 to February 2018, three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them, two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups. Results The sensitivity and specificity of T-SPOT.TB were 85.5% (153/179) and 71.4% (25/35) in the young and middle-aged group, 73.7% (56/76) and 58.7% (27/46) in the old group, respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (χ2=4.990, P=0.045). The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9% (177/179) and 94.3% (33/35) in the young and middle-aged group, 96.1% (73/76) and 89.1% (41/46) in the elderly group, respectively.There was no significant difference in sensitivity and specificity between the two groups (χ2=0.256, P=0.393、χ2=0.655, P=0.218). Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved, especially for those who can not tolerate pleural biopsy and elderly patients. Key words: Tuberculous pleurisy; T cell enzyme-linked immuno-spot assay; Adenosine deaminase; Age