The diagnostic value of TB-DNA,IGRAs and TB-Ab in pulmonary tuberculosis
Objective To explore the diagnostic value of tuberculosis deoxyribonucleic acid(TB-DNA),interferon-gamma release assays(IGRAs),tuberculosis antibody(TB-Ab),and their combination in pulmonary tuberculosis.Methods The clinical data of 154 patients suspected of having pulmonary tuberculo-sis and admitted to the Affiliated Hospital of Putian University from June 2022 to January 2023 were collected retrospectively.All patients underwent TB-DNA,IGRAs,and TB-Ab tests.The positivity rates of the differ-ent detection methods,as well as their sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy in diagnosing pulmonary tuberculosis,were evaluated.Receiver Operating Characteristic(ROC)curves were used to assess the diagnostic efficacy of the different detection methods for pulmonary tuberculosis.Results Among 154 patients suspected of pulmonary tuberculosis,107 were diag-nosed with pulmonary tuberculosis(the tuberculosis group),and 47 were diagnosed with other pulmonary dis-eases excluding pulmonary tuberculosis(the control group).The positive rates of TB-DNA,IGRAs,and TB-Ab in the tuberculosis group were higher than those in the control group(P<0.05).In diagnosing pulmo-nary tuberculosis,the sensitivity and accuracy of TB-DNA and IGRAs were higher than those of TB-Ab(P<0.05).and the negative predictive value of TB-DNA was higher than that of TB-Ab(P<0.05).Results from ROC curve analysis showed that the AUC of TB-DNA for diagnosing pulmonary tuberculosis was 0.851,sig-nificantly greater than that of IGRAs(0.770)or TB-Ab(0.770).The AUC of IGRAs was significantly greater than that of TB-Ab(P<0.05).The diagnostic sensitivity and accuracy of IGRAs combined with TB-DNA were significantly higher than those of IGRAs alone(P<0.05).The diagnostic sensitivity of IGRAs combined with TB-Ab was significantly higher than that of IGRAs or TB-Ab alone,and the diagnostic accuracy was sig-nificantly higher than that of TB-Ab(P<0.05).The sensitivity,negative predictive value,and accuracy of TB-DNA combined with TB-Ab were significantly higher than those of TB-Ab alone(P<0.05).There was no statistically significant difference in sensitivity,specificity,positive predictive value,negative predictive val-ue,or diagnostic accuracy among pairwise combination of TB-DNA,IGRAs and TB-Ab,and the combina-tion of all three for diagnosing pulmonary tuberculosis(P>0.05).Conclusion Compared to TB-Ab tests and IGRAs,TB-DNA tests have a higher diagnostic value for tuberculosis.The diagnostic efficiency of the pair-wise combination of T B-DNA,IGRAs and TB-Ab in cases of pulmonary tuberculosis was higher than that of single indicator detection.
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