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《Bulletin of Chinese Antituberculosis Association》 2005-01
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The predictive value of tuberculin test and serum anti-Mycobacterium tuberculosis antibody detection in diagnosis of adult pulmonary tuberculosis:a Bayesian analysis

Li Dexian,Lv Jiangqing,Kuang Haobing,et al. Guangzhou Chest Hospital,Guangzhou 510095,China  
Objective To evaluate the predictive value of tuberculin test and serum anti-Mycobacterium tuberculosis antibody detection for diagnosis of adult pulmonary tuberculosis.Methods Two hundred and ninety-four bacteriologically,patholgic histologically or cytologically proved adult patients received tuberculin skin test and detection of serum IgG antibody to a recombinant 38-kDa antigen from Mycobacterium tuberculosis,134 with TB,109 with chest tumors and 51 with pulmonary infections.The eligible non-TB patients were excluded those complicated with TB.The tuberculin test and the serum anti-Mycobacterium tuberculosis antibody detection were combined to form different positive results.To compare the diagnostic value of different combinations.The predictive value of a positive test and the predictive value of a negative test were estimated by Bayes's formula.Results The sensitivity of tuberculin test was higher than that of serum anti-Mycobacterium tuberculosis antibody detection.Whereas,the specificity of serum anti-Mycobacterium tuberculosis antibody detection was higher than that of tuberculin test.It can improve the diagnostic value while combined the tuberculin test with the serum anti-Mycobacterium tuberculosis antibody detection.If a positive result was defined as the diameter of PPD skin test ≥15mm or a positive of the serum anti-Mycobacterium tuberculosis antibody (criteria one),the predictive value of a negative test was the highest.If a positive result was defined as the diameter of PPD skin test ≥20mm and a positive of the serum anti-Mycobacterium tuberculosis antibody (criteria two),the predictive value of a positive test was the highest.When the prevalence of tuberculosis was 0.5%,5%,10%,30%,60% respectively.The predictive value of a negative test for criteria one was 0.999,0.987,0.972,0.901,0.723 respectively.And the predictive value of a positive test for criteria two was 1.000.Conclusion In regions with a high prevalence of TB,combination the tuberculin test with the serum anti-Mycobacterium tuberculosis antibody detection might still be useful for diagnosis of adult TB.It might exclude TB if one's diameter of PPD skin test 15mm and a negative of the serum anti-Mycobacterium tuberculosis antibody.It might be TB if one's diameter of PPD skin test ≥20 mm and a positive of the serum anti-Mycobacterium tuberculosis antibody.
【CateGory Index】: R446.6;R521
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