关键词: 肺结核, 肺外结核, T细胞斑点试验, 辅助诊断, 诊断价值

Abstract: Objective　To evaluate the auxiliary diagnostic value of T cells spot test of Mycobacterium tuberculosis infection (T⁃SPOT.TB) for pulmonary and extra⁃pulmonary tuberculosis among the elderly. Methods　A total of 173 elderly patients at ages of 60 years and older and with suspected tuberculosis that were admitted to People’s Hospital of Xinjiang Uygur Autonomous Region during the period from October 2022 through February 2024 were enrolled, and all patients underwent T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests. The etiological tests of MTB served as a gold standard, and the diagnostic values of T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests for pulmonary and extra⁃pulmonary tuberculosis were compared among the elderly patients. Results　Of the 173 elderly patients suspected of tuberculosis, there were 44 patients definitely diagnosed with pulmonary tuberculosis, 30 cases with extra⁃pulmonary tuberculosis, and 99 cases without tuberculosis. The sensitivities of T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests were 86.5%, 27.0% and 54.1% for diagnosis of tuberculosis. The sensitivities of T⁃SPOT.TB were 86.4% and 86.7% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with an 80.8% specificity for diagnosis of tuberculosis. The sensitivities of GeneXpert MTB/RIF were 56.8% and 50.0% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with a 100.0% specificity each, and the sensitivities of acid fast staining were 31.8% and 20.0% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with a 100.0% specificity each. In addition, the areas under the receiver operating characteristic curve were 0.836, 0.635 and 0.770 for diagnosis of tuberculosis with T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests among the elderly patients, respectively. Conclusion　T⁃SPOT.TB has a high auxiliary diagnostic value for both pulmonary and extra⁃pulmonary tuberculosis among elderly patients.

Key words: Pulmonary tuberculosis, Extra?pulmonary tuberculosis, T cells spot test, Auxiliary diagnosis, Diagnostic value