Objective To investigate the diagnostic value of serum interleukin-27(IL-27) combined with T cell spot test of tuberculosis infection (T-SPOT.TB) in bacterial negative pulmonary tuberculosis. Methods The clinical data of 168 patients with pulmonary tuberculosis admitted to our hospital from April 2023 to July 2024 were retrospectively analyzed. they were divided into bacteria positive pulmonary tuberculosis group (n=84) and bacteria negative pulmonary tuberculosis group (n=84). In addition, 84 healthy subjects were selected as control group (n=84). The clinical data of the patients were collected. T-SPOT. TB, serum IL-27 and peripheral blood erythrocyte sedimentation rate (ESR) were detected in all patients. The differences of T-SPOT. TB, serum IL-27 and ESR among the three groups were compared, and the receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of T-SPOT. TB, serum IL-27 alone and their combined detection for bacterial negative pulmonary tuberculosis. Results The positive rate of T-SPOT. TB in the tuberculosis group with positive bacteria and the tuberculosis group with negative bacteria was significantly higher than that in the control group. There was no significant difference in the positive rate of T-SPOT. TB detection between the positive pulmonary tuberculosis group and the negative pulmonary tuberculosis group. The serum IL-27 and peripheral blood ESR in the pulmonary tuberculosis group were higher than those in the control group. The serum IL-27 in the positive pulmonary tuberculosis group was higher than that in the negative pulmonary tuberculosis group. There was no significant difference in ESR between the positive pulmonary tuberculosis group and the negative pulmonary tuberculosis group. Taking the clinical comprehensive diagnosis as the reference standard, the efficacy of T-SPOT. TB, serum IL-27 alone and their combination in the diagnosis of pulmonary tuberculosis was as follows: the AUC of T-SPOT. TB diagnosis was 0.815, and the sensitivity and specificity were 84.52% (95% CI: 78.22-89.64) and 78.50% (95% CI: 68.28-86.81), respectively. The AUC of serum IL-27 was 0.848, the sensitivity and specificity were 65.48% (95% CI: 57.81-72.62) and 94.05% (95%CI: 86.74-98.03), respectively. The AUC of combined diagnosis was 0.936, the sensitivity and specificity were both 86.90% （95% CI: 80.80-91.63, 95% CI: 77.82-93.34). In the diagnosis of bacterial negative pulmonary tuberculosis, the diagnostic efficacy of serum IL-27 and T-SPOT. TB alone and in combination was as follows: the AUC of T-SPOT. TB diagnosis was 0.845, and the sensitivity and specificity were 82.14% (95% CI: 72.34-89.58) and 86.90% (95% CI: 77.82-93.34), respectively. The AUC of serum IL-27 was 0.867, the sensitivity and specificity were 91.67% (95% CI: 83.61-96.64) and 64.29% (95% CI: 53.13-74.42), respectively. The AUC of combined diagnosis was 0.955, and the sensitivity and specificity were 90.48% (95% CI: 82.12-95.84) and 86.90% (95% CI: 77.82-93.34), respectively. Conclusion Combined testing of both T-SPOT. TB and serum IL-27 would further improve the diagnostic efficacy in sputum-negative TB patients.
Key words
pulmonary tuberculosis /
bacterium negative /
interleukin-27 /
T cell spot test of tuberculosis infection /
diagnostic value
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