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. 2018 Oct;10(Suppl 28):S3378–S3391. doi: 10.21037/jtd.2018.08.84

Table 1. Laboratory diagnostics to detect active pulmonary tuberculosis in immunocompetent patients.

Sample Biologic laboratory diagnostic Sensitivity (%) Specificity (%)
Dermis Tuberculin skin test (TST) (5) 94–95 88
Serum Adenosine deaminase (ADA) level (6) 93 88
Interferon gamma release assay (IGRA) (5,7) 80–81 99
Sputum (expectorated) Acid-fast bacilli (AFB) smear, single (3,8,9) 36–54 >90
AFB smear, two (3,8) 65 >90
AFB smear, three (3,8) 70 >90
Nucleic acid amplification test (NAAT) (3) 66–96 85–98
Mycobacterial culture (3,9,10) 18–80 >95
Sputum (induction) AFB smear, single (3,8,9) 36–54 >90
AFB smear, two (3,8) 65 >90
AFB smear, three (3,8) 70 >90
NAAT (3) 66–96 85–98
Mycobacterial culture (3,9,10) 27–80 >95
Bronchoalveolar lavage (BAL) AFB smear (3,8) 53 >90
Mycobacterial culture (3,8) 68–95 90–97
Expectorated sputum after bronchoscopy Mycobacterial culture (3) 35–80 >95
Transbronchial biopsy (TBB) Microscopy/histopathology (3) 42–75 N/A
AFB smear (3) 9–56 >90
Pleural fluid ADA (3,11) 88–99 90–97
AFB smear (3) 10 >90
IGRA (3) 87–91 97
NAAT (3) 28–81 90–98
Mycobacterial culture (3) 89 90–97
Pleural biopsy Microscopy/histopathology (3) 69–97 N/A
AFB smear (3) 14–76 >90
NAAT (3) 90 98
Mycobacterial culture (3) 40–95 >90
Lymph node biopsy Microscopy/histopathology (3,12) 32–88 N/A
Mycobacterial culture (3,12) 62–93 >95
AFB smear (13) 25–50 >90
NAAT (3,12) 72–88 55–68
Gastric lavage (GL) AFB smear (14) 66 >95
Mycobacterial culture (13) 86 >95