The significance of T-SPOT.TB and erythrocyte sedimentation rate test in the diagnosis of simple pulmonary nodules in Xinjiang_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Ruiqiang ¹ , CHANG Jingjing ¹ , SHU Yin ² ,  DENG Yanchao ¹

1. Department of Thoracic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830001, P.R.China;
2. Xinjiang Medical University, Urumqi, 830001, P.R.China;

Corresponding author：

DENG Yanchao, Email: dych001@163.com

Keywords：

Tuberculosis T cell spot test; erythrocyte sedimentation rate; lung cancer; tuberculoma; pulmonary nodules

DOI：

10.7507/1007-4848.201910043

Video：

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Objective To investigate the diagnostic value of tuberculosis T cell spot test (T-SPOT.TB) and erythrocyte sedimentation rate (ESR) test in the diagnosis of simple pulmonary nodules in Xinjiang.Methods A retrospective analysis of 72 patients with asymptomatic simple pulmonary nodules in the Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University from October 2017 to July 2019 was performed. According to the pathological results, the patients were divided into a tuberculoma group [n=23, including 14 males and 9 females, aged 37-84 (56.91±12.73) years] and a lung cancer group [n=49, including 31 males and 18 females, aged 34-83 (61.71±10.15) years]. The predictive value of T-SPOT.TB and ESR results for the diagnosis of simple pulmonary nodules was evaluated.Results The positive rate of T-SPOT.TB in the tuberculoma group (69.60%) was higher than that in the lung cancer group (42.90%) (χ²=5.324, P=0.021), with a sensitivity of 69.56% and specificity of 57.14%; the positive ESR was 47.80% in the tuberculoma group and 59.20% in the lung cancer group, and no statistical difference was found between the two groups (χ²=0.981, P=0.322), with a sensitivity of 47.82% and specificity of 40.81%; the area under receiver operating characteristic curve (AUC) was 0.618, the 95% confidence interval of AUC was (0.479, 0.758), and the Youden’s index was 0.267 with a sensitivity of 69.60% and specificity of 57.10%. Difference in the T-SPOT.TB and ESR test results was statistically significant (χ²=4.986, P=0.026), but the correlation between the tests was weak with a Pearson contingency coefficient of 0.199. ESR results in patients with different ages were statistically different (χ²=7.343, P=0.025), but the correlation between age and ESR results was weak with a Pearson contingency coefficient of 0.239; T-SPOT.TB results in patients with different ages were not statistically different (χ²=0.865, P=0.649), and the correlation between age and ESR results was weak with a Pearson contingency coefficient of 0.084.Conclusion The diagnostic value of T-SPOT.TB and ESR tests is small in the diagnosis of simple pulmonary nodules.

Citation： SONG Ruiqiang, CHANG Jingjing, SHU Yin, DENG Yanchao. The significance of T-SPOT.TB and erythrocyte sedimentation rate test in the diagnosis of simple pulmonary nodules in Xinjiang. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 793-796. doi: 10.7507/1007-4848.201910043 Copy

1.	中华医学会呼吸病学分会肺癌学组, 中国肺癌防治联盟专家组. 肺结节诊治中国专家共识(2018 年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
2.	刘大伟, 朱建坤, 金锋, 等. 以磨玻璃样密度影为表现的早期肺癌并发肺结核患者的诊治分析. 中国防痨杂志, 2019, 41(1): 64-68.
3.	Bai C, Choi CM, Chu CM, et al. Evaluation of pulmonary nodules: Clinical practice consensus guidelines for Asia. Chest, 2016, 150(4): 877-893.
4.	中国物联网辅助肺结节诊治专家组. 物联网辅助肺结节诊治中国专家共识. 国际呼吸杂志, 2017, 37(8): 561-568.
5.	廖庆华, 董云旭, 陈瑜晖, 等. 非钙化结核球与周围型肺癌 CT 表现的对比研究. 广东医学, 2019, 40(12): 1711-1714.
6.	MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
7.	Chun EJ, Lee HJ, Kang WJ, et al. Differentiation between malignancy and inflammation in pulmonary ground-glass nodules: The feasibility of integrated (18)F-FDG PET/CT. Lung Cancer, 2009, 65(2): 180-186.
8.	廉娟雯, 党丽云, 许家玲, 等. 结核感染 T 细胞斑点试验在恶性肿瘤并发结核病患者中的应用价值. 中国防痨杂志, 2018, 40(4): 353-357.
9.	管立学, 李海波, 褚锦锦, 等. 外周血结核感染 T 细胞斑点试验对活动性结核的诊断价值. 中华医院感染学杂志, 2019, 29(3): 340-345.
10.	李爱英, 张红梅, 王淑梅, 等. T-SPOT.TB 技术在菌阴肺结核中的诊断价值. 包头医学院学报, 2018, 34(9): 13-15.
11.	华国新, 叶英. 探讨 T-SPOT 对结核病的诊断价值研究. 齐齐哈尔医学院学报, 2018, 39(19): 2236-2240.
12.	王肇华. T-SPOT 诊断肺癌合并肺结核的比较研究. 中国医药科学, 2018, 8(23): 239-241.
13.	黄毅, 党丽云, 郭琪, 等. 全血 γ-干扰素释放试验对结核病与恶性肿瘤患者检测结果的比较研究. 中国防痨杂志, 2015, 37(7): 774-777.
14.	全斌, 喻艳林. 肺结核合并肺癌的发生机制研究进展. 山东医药, 2015, 55(24): 104-106.
15.	林玲, 刘厚明, 邓群益, 等. γ-干扰素释放试验在肺结核和非结核分枝杆菌肺病鉴别诊断中的应用价值. 中国防痨杂志, 2014, 36(6): 477-481.
16.	Wang F, Hou H, Zhou H, et al. Use of TBAg/PHA ratio in distinguishing tuberculoma from cancer in solitary pulmonary nodule or mass. Clin Respir J, 2018, 12(3): 1174-1181.
17.	邸玉玮, 阳霞, 段玮, 等. ROC 曲线评价 NSE、CEA、CYFRA21-1 辅助肺癌诊断效能. 循证医学, 2015, 15(4): 237-241.
18.	周芬, 杨玉婷, 华彦珺, 等. CD4+T 细胞对肺结核诊断的 ROC 曲线分析. 中国卫生检验杂志, 2015, 25(19): 3280-3282.
19.	曾小红, 万程伟, 甘菊文, 等. INF-γ 释放试验联合胸部 CT 在老年涂阴肺结核早期诊断价值. 江西医药, 2019, 54(8): 980-982.
20.	Si ZL, Kang LL, Shen XB, et al. Adjuvant efficacy of nutrition support during pulmonary tuberculosis treating course: Systematic review and meta-analysis. Chin Med J (Engl), 2015, 128(23): 3219-3230.

1. 中华医学会呼吸病学分会肺癌学组, 中国肺癌防治联盟专家组. 肺结节诊治中国专家共识(2018 年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
2. 刘大伟, 朱建坤, 金锋, 等. 以磨玻璃样密度影为表现的早期肺癌并发肺结核患者的诊治分析. 中国防痨杂志, 2019, 41(1): 64-68.
3. Bai C, Choi CM, Chu CM, et al. Evaluation of pulmonary nodules: Clinical practice consensus guidelines for Asia. Chest, 2016, 150(4): 877-893.
4. 中国物联网辅助肺结节诊治专家组. 物联网辅助肺结节诊治中国专家共识. 国际呼吸杂志, 2017, 37(8): 561-568.
5. 廖庆华, 董云旭, 陈瑜晖, 等. 非钙化结核球与周围型肺癌 CT 表现的对比研究. 广东医学, 2019, 40(12): 1711-1714.
6. MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
7. Chun EJ, Lee HJ, Kang WJ, et al. Differentiation between malignancy and inflammation in pulmonary ground-glass nodules: The feasibility of integrated (18)F-FDG PET/CT. Lung Cancer, 2009, 65(2): 180-186.
8. 廉娟雯, 党丽云, 许家玲, 等. 结核感染 T 细胞斑点试验在恶性肿瘤并发结核病患者中的应用价值. 中国防痨杂志, 2018, 40(4): 353-357.
9. 管立学, 李海波, 褚锦锦, 等. 外周血结核感染 T 细胞斑点试验对活动性结核的诊断价值. 中华医院感染学杂志, 2019, 29(3): 340-345.
10. 李爱英, 张红梅, 王淑梅, 等. T-SPOT.TB 技术在菌阴肺结核中的诊断价值. 包头医学院学报, 2018, 34(9): 13-15.
11. 华国新, 叶英. 探讨 T-SPOT 对结核病的诊断价值研究. 齐齐哈尔医学院学报, 2018, 39(19): 2236-2240.
12. 王肇华. T-SPOT 诊断肺癌合并肺结核的比较研究. 中国医药科学, 2018, 8(23): 239-241.
13. 黄毅, 党丽云, 郭琪, 等. 全血 γ-干扰素释放试验对结核病与恶性肿瘤患者检测结果的比较研究. 中国防痨杂志, 2015, 37(7): 774-777.
14. 全斌, 喻艳林. 肺结核合并肺癌的发生机制研究进展. 山东医药, 2015, 55(24): 104-106.
15. 林玲, 刘厚明, 邓群益, 等. γ-干扰素释放试验在肺结核和非结核分枝杆菌肺病鉴别诊断中的应用价值. 中国防痨杂志, 2014, 36(6): 477-481.
16. Wang F, Hou H, Zhou H, et al. Use of TBAg/PHA ratio in distinguishing tuberculoma from cancer in solitary pulmonary nodule or mass. Clin Respir J, 2018, 12(3): 1174-1181.
17. 邸玉玮, 阳霞, 段玮, 等. ROC 曲线评价 NSE、CEA、CYFRA21-1 辅助肺癌诊断效能. 循证医学, 2015, 15(4): 237-241.
18. 周芬, 杨玉婷, 华彦珺, 等. CD4+T 细胞对肺结核诊断的 ROC 曲线分析. 中国卫生检验杂志, 2015, 25(19): 3280-3282.
19. 曾小红, 万程伟, 甘菊文, 等. INF-γ 释放试验联合胸部 CT 在老年涂阴肺结核早期诊断价值. 江西医药, 2019, 54(8): 980-982.
20. Si ZL, Kang LL, Shen XB, et al. Adjuvant efficacy of nutrition support during pulmonary tuberculosis treating course: Systematic review and meta-analysis. Chin Med J (Engl), 2015, 128(23): 3219-3230.

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The significance of T-SPOT.TB and erythrocyte sedimentation rate test in the diagnosis of simple pulmonary nodules in Xinjiang

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