Diagnostic Value of TB-IGRA, PPD, TB-DNA-PCR and ADA in Tuberculous Pleural Effusion

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.