The value of CT enterography and tuberculin skin test for T cells combined with serum IL-6 and ESR in the differen-tial diagnosis of intestinal tuberculosis and lymphoma

TAN Juan; MAIMAITIMING•Mahemuti; MA Haihong; YE Hongda; ZHU Jiankang

doi:10.20258/j.cnki.1006-9011.2025.12.018

Abstract：Objective To analyze the differential diagnostic value of CT enterography(CTE),tuberculosis infection T cell spot test(T-SPOT.TB)combined with serum interleukin-6(IL-6)and erythrocyte sedimentation rate(ESR)in intestinal tubercu-losis and lymphoma.Methods Fifty-four patients with intestinal tuberculosis(intestinal tuberculosis group)and 48 patients with lymphoma(lymphoma group)were selected.CTE and T-SPOT.TB tests were conducted on patients in both groups.The con-sistency between the CTE and T-SPOT.TB tests and the pathological diagnosis was analyzed using the Kappa test.In addition,the serum IL-6 was detected by electrochemiluminescence method,and the serum ESR was detected by the Weil's sedimentation rate method.The ROC curve was drawn to analyze the value of CTE,T-SPOT.TB,IL-6,and ESR alone and in combination for the differential diagnosis of lymphoma and intestinal tuberculosis.Results There were statistical significances in the lesion site(multi-stage lesion,intestinal stenosis),intestinal wall characteristics(layered thickening,intestinal wall gas accumulation,in-testinal wall edema zone,intestinal wall thickness),and extraintestinal manifestations(lymph node enlargement,intestinal per-foration)between intestinal tuberculosis group and lymphoma group(all P<0.05).According to the diagnosis of CTE examina-tion,43 cases were lymphoma,with a detection rate of 86.05%(37/43);59 cases were intestinal tuberculosis,with a detection rate of 81.36%(48/59).There were 11 cases of lymphoma missed by CTE examination,with a missed diagnosis rate of 22.92%(11/48);and 6 cases of intestinal tuberculosis were misdiagnosed by CTE examination,with a misdiagnosis rate of 11.11%(6/54),indicating high consistency with pathological diagnosis(Kappa=0.663,P<0.05).According to T-SPOT.TB examination,di-agnosis showed that 58 cases were intestinal tuberculosis,with a detection rate of 79.31%(46/58);44 cases were lymphoma,with a detection rate of 81.82%(36/44).A total of 44 cases were diagnosed with lymphoma,with a detection rate of 81.82%(36/44),and there was a high consistency with the pathological diagnosis(Kappa=0.732,P<0.05).The AUCs of CTE,T-SPOT.TB,IL-6,ESR alone and their combination for differentiating intestinal tuberculosis from lymphoma were 0.830,0.801,0.820,0.700 and 0.963 respectively.The combined diagnosis was superior to the individual ones(all P<0.05).Conclusion The com-bined use of CTE,T-SPOT.TB,and serum IL-6 and ESR in the differential diagnosis of intestinal tuberculosis and lymphoma has a relatively high value.