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Abstract：
UNASSIGNED: The clinical challenge of differentiating suspected tuberculosis with positive T-SPOT.TB results persist. This study aims to investigate the utility of the Systemic Immune-Inflammation Index (SII), Fibrinogen, and T-SPOT.TB in distinguishing between active pulmonary tuberculosis (PTB) and non-tuberculous lung diseases.
UNASSIGNED: A retrospective analysis included 1,327 cases of active PTB with positive T-SPOT.TB results and 703 cases of non-tuberculous lung diseases from May 2016 to December 2020 at Meizhou People\'s Hospital. These were designated as the case group and the control group, respectively. The detection indicators of T-SPOT.TB: Early Secreted Antigenic Target 6 (ESAT-6), Culture Filtrate Protein 10 (CFP-10), as well as SII and Fibrinogen levels-were compared and analyzed for association and joint diagnostic value between the two groups.
UNASSIGNED: The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all p < 0.001). In the case group, SII and Fibrinogen did not correlate with ESAT-6 and CFP-10 (∣rs∣ all < 0.3) but were positively correlated with C-reactive protein (CRP; rs all > 0.3). SII and Fibrinogen values in smear-positive pulmonary tuberculosis were higher than in smear-negative cases (all p < 0.05). The optimal diagnostic thresholds for ESAT-6, CFP-10, SII, and Fibrinogen in differentiating between active PTB and non-tuberculous lung diseases were 21.50 SFCs/106 PBMC, 22.50 SFCs/106 PBMC, 2128.32, and 5.02 g/L, respectively. Regression logistic analysis showed that ESAT-6 < 21.5 (OR: 1.637, 95% CI: 1.311-2.043, p < 0.001), CFP-10 < 22.5 (OR: 3.918, 95% CI: 3.138-4.892, p = 0.025), SII < 2128.32 (OR: 0.763, 95% CI: 0.603-0.967, p < 0.001), and FIB < 5.02 (OR: 2.287, 95% CI: 1.865-2.806, p < 0.001) were independent risk factors for active PTB. The specificity for ESAT-6 + CFP-10, ESAT-6 + CFP-10 + SII, ESAT-6 + CFP-10 + FIB, and ESAT-6 + CFP-10 + SII + FIB was 82.5%, 83.2%, 95.8%, and 80.1%, respectively, while sensitivity was 52.6%, 53.0%, 55.8%, and 44.7%, and positive predictive values were 85.0%, 85.6%, 84.1%, and 89.6%, respectively.
UNASSIGNED: SII and Fibrinogen are positively correlated with the degree of tuberculosis inflammation and the bacterial load of Mycobacterium tuberculosis. The combined detection of SII, Fibrinogen, and T-SPOT.TB is significant in distinguishing between active PTB with positive T-SPOT.TB results and non-tuberculous lung diseases.
UNASSIGNED: A retrospective analysis included 1,327 cases of active PTB with positive T-SPOT.TB results and 703 cases of non-tuberculous lung diseases from May 2016 to December 2020 at Meizhou People\'s Hospital. These were designated as the case group and the control group, respectively. The detection indicators of T-SPOT.TB: Early Secreted Antigenic Target 6 (ESAT-6), Culture Filtrate Protein 10 (CFP-10), as well as SII and Fibrinogen levels-were compared and analyzed for association and joint diagnostic value between the two groups.
UNASSIGNED: The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all p < 0.001). In the case group, SII and Fibrinogen did not correlate with ESAT-6 and CFP-10 (∣rs∣ all < 0.3) but were positively correlated with C-reactive protein (CRP; rs all > 0.3). SII and Fibrinogen values in smear-positive pulmonary tuberculosis were higher than in smear-negative cases (all p < 0.05). The optimal diagnostic thresholds for ESAT-6, CFP-10, SII, and Fibrinogen in differentiating between active PTB and non-tuberculous lung diseases were 21.50 SFCs/106 PBMC, 22.50 SFCs/106 PBMC, 2128.32, and 5.02 g/L, respectively. Regression logistic analysis showed that ESAT-6 < 21.5 (OR: 1.637, 95% CI: 1.311-2.043, p < 0.001), CFP-10 < 22.5 (OR: 3.918, 95% CI: 3.138-4.892, p = 0.025), SII < 2128.32 (OR: 0.763, 95% CI: 0.603-0.967, p < 0.001), and FIB < 5.02 (OR: 2.287, 95% CI: 1.865-2.806, p < 0.001) were independent risk factors for active PTB. The specificity for ESAT-6 + CFP-10, ESAT-6 + CFP-10 + SII, ESAT-6 + CFP-10 + FIB, and ESAT-6 + CFP-10 + SII + FIB was 82.5%, 83.2%, 95.8%, and 80.1%, respectively, while sensitivity was 52.6%, 53.0%, 55.8%, and 44.7%, and positive predictive values were 85.0%, 85.6%, 84.1%, and 89.6%, respectively.
UNASSIGNED: SII and Fibrinogen are positively correlated with the degree of tuberculosis inflammation and the bacterial load of Mycobacterium tuberculosis. The combined detection of SII, Fibrinogen, and T-SPOT.TB is significant in distinguishing between active PTB with positive T-SPOT.TB results and non-tuberculous lung diseases.
摘要：
■区分T-SPOT阳性的疑似结核病的临床挑战。结核病结果持续存在。本研究旨在探讨全身免疫炎症指数（SII）的效用，纤维蛋白原,还有T-SPOT.结核病在区分活动性肺结核（PTB）和非结核性肺部疾病中的作用。
■回顾性分析包括1,327例T-SPOT阳性的活动性PTB。2016年5月至2020年12月梅州市人民医院结核病检测结果及703例非结核性肺病。这些被指定为病例组和对照组，分别。T-SPOT的检测指标。TB：早期分泌的抗原靶标6（ESAT-6），培养滤液蛋白10（CFP-10），以及SII和纤维蛋白原水平-比较和分析两组间的关联和联合诊断价值.
■病例组显示ESAT-6，CFP-10，SII，和纤维蛋白原与对照组相比(所有p<0.001)。在案例组中，SII和纤维蛋白原与ESAT-6和CFP-10不相关（参加rs所有<0.3），但与C反应蛋白（CRP；rs所有>0.3）呈正相关。涂片阳性肺结核的SII和纤维蛋白原值均高于涂片阴性肺结核（均p<0.05）。ESAT-6、CFP-10、SII、在区分活动性PTB和非结核性肺病中的纤维蛋白原为21.50SFCs/106PBMC，22.50SFC/106PBMC，2128.32和5.02g/L，分别。回归Logistic分析显示ESAT-6<21.5(OR:1.637,95%CI:1.311-2.043,p<0.001),CFP-10<22.5（OR：3.918，95％CI：3.138-4.892，p=0.025），SII<2128.32（OR：0.763，95%CI：0.603-0.967，p<0.001），FIB<5.02（OR：2.287，95％CI：1.865-2.806，p<0.001）是活动性PTB的独立危险因素。对ESAT-6+CFP-10、ESAT-6+CFP-10+SII的特异性,ESAT-6+CFP-10+FIB,ESAT-6+CFP-10+SII+FIB为82.5%,83.2%,95.8%,80.1%,分别,灵敏度为52.6%，53.0%,55.8%,和44.7%，阳性预测值为85.0%，85.6%,84.1%,和89.6%，分别。
■SII和纤维蛋白原与结核炎症程度和结核分枝杆菌的细菌负荷呈正相关。SII的联合检测，纤维蛋白原,还有T-SPOT.TB在区分活性PTB与阳性T-SPOT之间具有重要意义。结核病结果和非结核性肺病。
■回顾性分析包括1,327例T-SPOT阳性的活动性PTB。2016年5月至2020年12月梅州市人民医院结核病检测结果及703例非结核性肺病。这些被指定为病例组和对照组，分别。T-SPOT的检测指标。TB：早期分泌的抗原靶标6（ESAT-6），培养滤液蛋白10（CFP-10），以及SII和纤维蛋白原水平-比较和分析两组间的关联和联合诊断价值.
■病例组显示ESAT-6，CFP-10，SII，和纤维蛋白原与对照组相比(所有p<0.001)。在案例组中，SII和纤维蛋白原与ESAT-6和CFP-10不相关（参加rs所有<0.3），但与C反应蛋白（CRP；rs所有>0.3）呈正相关。涂片阳性肺结核的SII和纤维蛋白原值均高于涂片阴性肺结核（均p<0.05）。ESAT-6、CFP-10、SII、在区分活动性PTB和非结核性肺病中的纤维蛋白原为21.50SFCs/106PBMC，22.50SFC/106PBMC，2128.32和5.02g/L，分别。回归Logistic分析显示ESAT-6<21.5(OR:1.637,95%CI:1.311-2.043,p<0.001),CFP-10<22.5（OR：3.918，95％CI：3.138-4.892，p=0.025），SII<2128.32（OR：0.763，95%CI：0.603-0.967，p<0.001），FIB<5.02（OR：2.287，95％CI：1.865-2.806，p<0.001）是活动性PTB的独立危险因素。对ESAT-6+CFP-10、ESAT-6+CFP-10+SII的特异性,ESAT-6+CFP-10+FIB,ESAT-6+CFP-10+SII+FIB为82.5%,83.2%,95.8%,80.1%,分别,灵敏度为52.6%，53.0%,55.8%,和44.7%，阳性预测值为85.0%，85.6%,84.1%,和89.6%，分别。
■SII和纤维蛋白原与结核炎症程度和结核分枝杆菌的细菌负荷呈正相关。SII的联合检测，纤维蛋白原,还有T-SPOT.TB在区分活性PTB与阳性T-SPOT之间具有重要意义。结核病结果和非结核性肺病。
