Clinical utility of LAM,IFN-γ,and ADA combined with a clinical scoring system for early diagnosis of active pulmonary tuberculosis

KANG Jianjun; WANG Haie; LI Chunmei; WANG Qiyuan

doi:10.3969/j.issn.1007-8134.2025.02.008

Abstract：Objective To investigate the diagnostic value ofcombining lipoarabinomannan(LAM),interferon-γ(IFN-γ),serum adenosine deaminase(ADA),and clinical diagnostic scoring system for early detection of active pulmonary tuberculosis.Methods A retrospective study was conducted on 63 patients diagnosed with active pulmonary tuberculosis(case group)and 63 healthy individuals(control group)recruitedfromYulin FirstHospital between January 2023 and April 2024.We compared differencesbetween the two groupsin serum LAM-IgGpositivity,IFN-γ levels,ADA levels,and clinical diagnostic scores derived from the pulmonary tuberculosis clinical diagnostic scoring system.Potential diagnostic indicators were screened using univariate and multivariate logistic regression analyses.Additionally,we evaluated the diagnostic performance of individual factors in identifying active pulmonary tuberculosis at an early stageby receiver operating characteristic(ROC)curves.Results The case group showed significantly higher serum LAM-IgG positivity(66.67％vs.28.57％),IFN-γ levels(50.60 pg/mL vs.40.40 pg/mL),ADA levels(27.62 U/L vs.24.79 U/L),and clinical diagnostic scores(8.21 vs.3.51)compared to the control group(P＜0.05).Multivariate logistic regression analysisidentified LAM-IgG positivity(OR=2.232),high level of IFN-γ(OR=1.628),high level of ADA(OR=2.176),and clinical diagnostic score(OR=2.971)asinfluence factorof active pulmonary tuberculosis(P＜0.05).ROC analysis revealed area under curves(AUC)＞0.6 for individual markers,while the combination achieved the highest AUC of 0.936 with 87.8％sensitivity and 92.5％specificity.Conclusion The combination of LAM-IgG,IFN-γ,ADA,and clinical diagnostic scoring system significantly improves the sensitivity and specificity for diagnosing active pulmonary tuberculosis,thus holding significant clinical importance in enabling early detection of the disease.