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Significance of serum neopterin level in diagnosis of active pulmonary tuberculosis

Keywords: tuberculosis , pulmonary;enzyme-linked immunosorbent assay;sensitivity and specificity

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Abstract:

Objective To investigate the sensitivity and specificity of serum neopterin(Np) level in diagnosis of active pulmonary tuberculosis.Methods Patients with pulmonary tuberculosis,admitted to Xinjiang Chest Hospital from Apr.2009 to May 2010,were consecutively enrolled in present study.Serum neopterin level was determined with enzyme linked immunosorbent assay(ELISA) in the next morning of admission.VCG purified protein derivative test(PPD) was concurrently performed.Results Fifty-eight cases with active(group A) and 18 with stable(group S) pulmonary tuberculosis were recruited,and 32 healthy volunteers served as control(group C).The mean Np level was significantly higher in group A(54.14±19.85 nmol/L) than in group S(29.51±8.23 nmol/L) and group C(20.67±9.68 nmol/L,P < 0.01).No statistical difference was found between group S and group C(P > 0.05).Among patients with active pulmonary tuberculosis,the mean Np level increased significantly in cases with the fibro-cavitative pulmonary tuberculosis(77.43±22.13),compared with those cases with invasive(46.07±13.04) and hematogenous disseminated pulmonary tuberculosis(48.48±8.34 nmol/L,P < 0.01),while no statistical difference existed between the latter two.The receiver operating characteristic(ROC) curve showed that the area under curve(AUC) was 0.951 in the cutoff value of 36.73 nmol/L,and the sensitivity and specificity were 86% and 92% for predicting active pulmonary tuberculosis,and it was significantly higher than PPD test(P < 0.01),in which the sensitivity was 52% and specificity was 78%.Conclusions Np level may serve as one of the important adjunctive parameters for early diagnosis of active pulmonary tuberculosis due to its high sensitivity and specificity.

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