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Abstract Objective To study the clinical application value of T cell spot test of tuberculosis infection(T-SPOT.TB) in the diagnosis of early bone tuberculosis.Methods A prospective study of 80 suspected cases of TuliI and stage Ⅱ tuberculosis admitted to the Second People's Hospital of North Guangdong from July 2017 to December 2018 was conducted.There were 43 males and 37 females with an average age of (45.25±7.62) years (range，10~75 years).All cases met the inclusion criteria.The subjects voluntarily signed the informed consent form for clinical research.All cases were tested for tuberculin pure protein derivative test (PPD skin test)，anti-tuberculosis antibody (TB-ab) test，tuberculosis pathogen test (direct smear and tuberculosis tuberculosis culture) and TSPOT.TB test. The pathological examination was used as the gold standard for diagnosis of bone tuberculosis.The cases of bone tuberculosis were classified into group A，and the cases of non-tuberculosis were classified into group B.The sensitivity of PPD skin test，TB-ab，pathogen examination and TSPOT.TB were observed in the two groups.Results The sensitivity of TSPOT.TB in the diagnosis of early bone tuberculosis was 86.54%，specificity was 92.86%，and positive predictive value was 95.74%，which was significantly higher than PPD skin test and anti-tuberculosis antibody (P＝0.017)；TSPOT.TB specificity The positive predictive value was lower than that of the tuberculosis pathogen examination (P＝0.871)，and the sensitivity was significantly higher than that of the tuberculosis pathogen examination (P＝0.001).TSPOT.TB diagnoses bone tuberculosis with the largest area under the ROC curve and the highest diagnostic value.Conclusion TSPOT.TB has high sensitivity，specificity and positive predictive value for early diagnosis of bone tuberculosis.The detection is safe，reliable and rapid，and it is worthy of clinical application.
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