Diagnostic value of the combined test of leukocytes in urine and TB-DOT and T-SPOT.TB in blood for urinary tuberculosis

尿液白细胞联合血液结核病直接观察试验(TB-DOT)和结核病斑点试验(T-SPOT.TB)对泌尿系统结核病的诊断价值

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Abstract

BACKGROUND: This study aims to evaluate the clinical utility of routine urinary tests and renal function assessments, as well as the Tuberculosis antibody test (TB-DOT) and T-cell spot tests for TB infection (T-SPOT.TB), either individually or in combination, for diagnosing urinary tuberculosis (UTB). METHODS: We conducted a retrospective analysis of urinary routine tests, renal function tests, TB-DOT, and T-SPOT.TB-administered alone or in combination-in 95 patients suspected of having UTB from January 2020 to December 2022 at our institution. RESULTS: Significant differences were observed in the levels or positivity of white blood cells (WBC), red blood cells (RBC), creatinine (Crea), TB-DOT, and T-SPOT.TB between the UTB group and the non-UTB group (P < 0.05). Among the individual tests, T-SPOT.TB exhibited the highest specificity and positive predictive value (PPV), while WBC demonstrated the highest area under the curve (AUC). Both TB-DOT and RBC showed relatively good sensitivity. Additionally, WBC levels correlated with both TB-DOT and T-SPOT.TB results. The combination of WBC, TB-DOT, and T-SPOT.TB provided the best sensitivity, negative predictive value (NPV), and AUC when evaluated in parallel with the other tests. CONCLUSION: For the early identification of UTB, the sensitivity of T-SPOT.TB and TB-DOT tests is superior to that of routine urinary and renal function tests. The parallel combination of WBC, TB-DOT, and T-SPOT.TB offers enhanced diagnostic efficacy for UTB, facilitating rapid clinical diagnosis.

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