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本题通过淋巴腺结核穿刺细胞学分型诊断研究,为淋巴腺结核诊断提供简单、快速、实用、准确方法,并同时应用4种结核抗体标志物,对淋巴腺结核不同病期进行检测,结果表明,结核抗体酶联免疫测定法(简称EILSA)阳性率、敏感度最高,达到78%,特异性为56.3%;新一代结核抗体快速诊断法(DIGFA METHOD)(简称TB-D)阳性率、敏感度次之,为75.5%,特异性为68.8%;快速结核抗体IgG(简称TB-C)阳性率、敏感度为58.3%,而特异性为100%;快速免疫色谱法(简称ICT)阳性率、敏感度最差,仅占29.1%,但特异性较高为100%。结论:结核抗体ESLAS法、TB-D法灵敏度较高,分别占78%,75.5%,但特异性较差,分别占56.3%,68.8%;而ICT、TB-C虽然阳性率、敏感度较低,分别占29.1%,58.3%,但诊断特异性最高,均占100%。说明依ICT、TB-C两法诊断淋巴腺结核分别有70.9%,41.7%淋巴腺结核病人误诊或漏诊。如以EILSA、TB-D法为诊断指标,其中有22%,24.5%淋巴腺结核病人误诊或漏诊,诊断有效率为55.8%;OT试验敏感度、特异性更差分别占29.1%,70%,诊断有效率最低45.6%。我们将淋巴腺结核穿刺细胞学分型诊断与OT试验、EILSA、TB-D、TB-C、ICT、PCR、X线计算机断层撮影(CT)、磁共振(MRI)等多种对比试验中,试验与临床研究资料分析证明,淋巴腺结核穿刺细胞学分型诊断敏感度可高达98.4%,准确率99.2%,诊断有效率为98.4%,明显优于其它方法,是目前诊断淋巴腺结核最理想、最可靠的诊断指标。
The diagnosis of lymphnode tuberculosis by cytological diagnosis of lymph nodes provide a simple, rapid, practical and accurate method for the diagnosis of lymph node tuberculosis. At the same time, four kinds of tuberculosis antibody markers were used to detect different stages of lymph node tuberculosis. The positive rate of tuberculosis antibody enzyme-linked immunosorbent assay (EILSA) was the highest, with the highest sensitivity of 78% and the specificity of 56.3%. The positive rate of the new generation of TB antibody (TB-D) and the sensitivity Followed by 75.5% and specificity of 68.8%. The positive rate of fast TB antibody IgG (TB-C) was 58.3% and the specificity was 100%. The positive rate of rapid immunochromatography (ICT) The worst sensitivity, only 29.1%, but the higher the specificity of 100%. Conclusion: The sensitivity of tuberculosis antibody ESLAS and TB-D were 78% and 75.5% respectively, but the specificity was poor, accounting for 56.3% and 68.8% respectively; while the positive rates of ICT and TB-C were higher than those of TB-C Low, accounting for 29.1%, 58.3%, respectively, but the highest diagnostic specificity, accounting for 100%. According to ICT, TB-C two methods to diagnose lymph node tuberculosis were 70.9%, 41.7% of lymph node tuberculosis patients misdiagnosis or missed diagnosis. If EILSA, TB-D method for the diagnosis of indicators, of which 22%, 24.5% misdiagnosis or misdiagnosis of lymph node tuberculosis patients, the diagnostic efficiency was 55.8%; OT test sensitivity and specificity were worse accounted for 29.1%, 70% , The lowest diagnostic efficiency 45.6%. We compare the diagnosis of lymph node type cytology with OT test, EILSA, TB-D, TB-C, ICT, PCR, computed tomography and magnetic resonance imaging And clinical research data analysis shows that lymphatic puncture cytology typing diagnostic sensitivity as high as 98.4%, the accuracy rate of 99.2%, the diagnostic efficiency was 98.4%, significantly better than other methods, is the best diagnosis of lymph node tuberculosis, the most Reliable diagnostic indicator.