{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:33:02Z","timestamp":1792801982834,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The clinical challenge of differentiating suspected tuberculosis with positive T-SPOT.TB results persist. This study aims to investigate the utility of the Systemic Immune-Inflammation Index (SII), Fibrinogen, and T-SPOT.TB in distinguishing between active pulmonary tuberculosis (PTB) and non-tuberculous lung diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis included 1,327 cases of active PTB with positive T-SPOT.TB results and 703 cases of non-tuberculous lung diseases from May 2016 to December 2020 at Meizhou People\u2019s Hospital. These were designated as the case group and the control group, respectively. The detection indicators of T-SPOT.TB: Early Secreted Antigenic Target 6 (ESAT-6), Culture Filtrate Protein 10 (CFP-10), as well as SII and Fibrinogen levels\u2014were compared and analyzed for association and joint diagnostic value between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all <jats:italic>p<\/jats:italic> &amp;lt; 0.001). In the case group, SII and Fibrinogen did not correlate with ESAT-6 and CFP-10 (\u2223rs\u2223 all &amp;lt; 0.3) but were positively correlated with C-reactive protein (CRP; rs all &amp;gt; 0.3). SII and Fibrinogen values in smear-positive pulmonary tuberculosis were higher than in smear-negative cases (all <jats:italic>p<\/jats:italic> &amp;lt; 0.05). The optimal diagnostic thresholds for ESAT-6, CFP-10, SII, and Fibrinogen in differentiating between active PTB and non-tuberculous lung diseases were 21.50 SFCs\/10<jats:sup>6<\/jats:sup> PBMC, 22.50 SFCs\/10<jats:sup>6<\/jats:sup> PBMC, 2128.32, and 5.02 g\/L, respectively. Regression logistic analysis showed that ESAT-6\u2009&amp;lt;\u200921.5 (OR: 1.637, 95% CI: 1.311\u20132.043, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), CFP-10\u2009&amp;lt;\u200922.5 (OR: 3.918, 95% CI: 3.138\u20134.892, <jats:italic>p<\/jats:italic> = 0.025), SII &amp;lt; 2128.32 (OR: 0.763, 95% CI: 0.603\u20130.967, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.001), and FIB &amp;lt; 5.02 (OR: 2.287, 95% CI: 1.865\u20132.806, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) were independent risk factors for active PTB. The specificity for ESAT-6\u2009+\u2009CFP-10, ESAT-6\u2009+\u2009CFP-10\u2009+\u2009SII, ESAT-6\u2009+\u2009CFP-10\u2009+\u2009FIB, and ESAT-6\u2009+\u2009CFP-10\u2009+\u2009SII\u2009+\u2009FIB was 82.5%, 83.2%, 95.8%, and 80.1%, respectively, while sensitivity was 52.6%, 53.0%, 55.8%, and 44.7%, and positive predictive values were 85.0%, 85.6%, 84.1%, and 89.6%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SII and Fibrinogen are positively correlated with the degree of tuberculosis inflammation and the bacterial load of <jats:italic>Mycobacterium tuberculosis<\/jats:italic>. The combined detection of SII, Fibrinogen, and T-SPOT.TB is significant in distinguishing between active PTB with positive T-SPOT.TB results and non-tuberculous lung diseases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2024.1382665","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T04:53:30Z","timestamp":1714020810000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Integrating systemic immune-inflammation index, fibrinogen, and T-SPOT.TB for precision distinction of active pulmonary tuberculosis in the era of mycobacterial disease research"],"prefix":"10.3389","volume":"15","author":[{"given":"Zhikang","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifang","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feiqiu","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jinf.2022.10.041","article-title":"Clinical utility of C-reactive protein-based triage for presumptive pulmonary tuberculosis in south African adults","volume":"86","author":"Calderwood","year":"2023","journal-title":"J. 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