Objective      To study the differential diagnosis value of T-cell spot test of tuberculosis (T-SPOT.TB) between intestinal tuberculosis and Crohn’s disease.       Methods      Sixty-four patients with intestinal tuberculosis (ITB) or Crohn’s disease (CD) in our department from Mar

2012 to Dec

2014 were retrospectively analyzed. The ITB patients were 37.3±16.5 years old (ranged from 14 to 77)

and 19 males and 16 females. The CD patients were 35.2±18.9 years old (ranged from 15 to 74)

were 13 males and 16 females. The sensitivity

specificity

positive predictive value

and negative predictive value of T-SPOT.TB in differential diagnosis between ITB and CD were evaluated by analyzing the clinical manifestations

laboratory examination results

endoscopic findings and pathological results.       Results      The incidences of diarrhea (31.4% vs 65.5%

Chi-square=7.41

P0.01)

hematochezia (8.6% vs 41.3%

Chi-square=9.51

P0.01)

obstruction (11.4% vs 34.5%

Chi-square=3.799

P0.05) and bowel perforation (0% vs 10.3%

Chi-square=3.799

P0.05) in the ITB patients were significantly lower than those in the CD patients. The positive rate of T-SPOT.TB test in the ITB patients was higher than that in the CD patients (91.4% vs 6.9%

Chi-square=45.508

P0.01)

with sensitivity and positive predictive value of 91.4%  and 94.1%

respectively and specificity and negative predictive value of 93.1% and 90.0%

respectively. Circular ulcer (20.0% vs 3.4%

Chi-square=3.972

P0.05) and ileocecum involvement (77.1% vs 51.7%

Chi-square=4.542

P0.05) were significantly more common in the ITB patients

while higher incidences of longitudinal ulcer (2.9% vs 20.6%

Chi-square=5.177

P0.05)

pebble levy (0% vs 27.6%

Chi-square=11.034

P0.01) and luminal stenosis (14.3% vs 37.9%

Chi-square=4.729

P0.05) were found in the CD patients as compared with the ITB patients. Lymph cell aggregation incidence of ITB was significantly lower than that of CD (31.4% vs 86.2%

Chi-square=19.338

P0.01)

and granuloma formation was significantly more common in ITB as compared with CD (42.8% vs 0%

Chi-square=16.233

P0.01).       Conclusion      T-SPOT.TB blood test is useful for differential diagnosis between ITB and CD with high sensitivity and specificity.