Integrating systemic immune-inflammation index, fibrinogen, and T-SPOT.TB for precision distinction of active pulmonary tuberculosis in the era of mycobacterial disease research

• Published in: Frontiers in microbiology 2024-04, Vol.15, p.1382665-1382665
• Main Authors: Yu, Zhikang, Shang, Zifang, Huang, Qingyan, Wen, Feiqiu, Patil, Sandip
• Format: Article
• Language: English
• Subjects: fibrinogen; Microbiology; pulmonary disease differentiation; systemic immune-inflammation index (SII); T-SPOT.TB; tuberculosis diagnosis
• ISSN: 1664-302X; 1664-302X
• DOI: 10.3389/fmicb.2024.1382665

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. 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. The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all < 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 < 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/10 PBMC, 22.50 SFCs/10 PBMC, 2128.32, and 5.02 g/L, respectively. Regression logistic analysis showed that ESAT-6