Abstract: Objective　To evaluate the diagnostic value of T-cell spot test (T-SPOT.TB), smear test and tuberculin skin test (TST) in tuberculosis of children. Method　A retrospective study was conducted in 299 hospitalized children suspected of tuberculosis from January to December 2015 to compare the diagnostic value of three detection methods in tuberculosis of children. Results　Of 299 children, 135 had tuberculosis (52 confirmed and 83 clinically diagnosed) and 164 had nontuberculosis. The sensitivity and specificity of T-SPOT.TB, smear test and TST in the diagnosis of tuberculosis were 78.20%, 24.24% and 42.98% (P<0.001), and 97.56%, 100% and 96.52% (P=0.107), respectively; Yoden index was 75.76%, 24.24% and 39.50%, and positive predictive value was 96.30%, 100% and 96.52%, and negative predictive value was 84.66%, 55.36% and 68.14%, respectively. The sensitivity of T-SPOT.TB, smear test and TST were 67.35%, 20.83% and 51.28% in children<5 years old; and 84.52%, 38.67% and 26.19% in children>5 years old, respectively. In tuberculosis group and extrapulmonary tuberculosis group, the sensitivity of T-SPOT.TB was 86.02% and 60%, and TST 44.71% and 37.93%, and smear test only 27.96% and 18.42% respectively. In pulmonary tuberculosis group and the multi-organ (including lung) tuberculosis group, the sensitivity of T-SPOT.TB was 83.87% and 90.32%, TST 53.45% and 25.93%, and smear test 27.41% and 29.03%, respectively. Conclusion　T-SPOT.TB is high in sensitivity, specificity, Yoden index, positive predictive value and negative predictive value. It has higher sensitivity in different age groups, pulmonary tuberculosis and extrapulmonary tuberculosis children.

Key words: 　tuberculosis;　T-cell spot test;　smears test;　tuberculin skin test;　child