Britton W J, Gilbert G L, Wheatley J, Leslie D, Rothel J S, Jones S L, Bradley P
Centenary Institute of Cancer, Medicine and Cell Biology, Locked Bag No. 6, Newtown NSW 2042, Australia.
Tuberculosis (Edinb). 2005 May;85(3):137-45. doi: 10.1016/j.tube.2004.06.003.
Nine university-affiliated chest clinics in Australia.
To evaluate the sensitivity of a whole blood human gamma-interferon assay (HGIA, QuantiFERON-TB) for specific T lymphocyte responses and Tuberculin skin testing (TST) for the detection of Mycobacterium tuberculosis infection in subjects with culture-proven M. tuberculosis disease (TBCP).
Prospective testing of 129 patients with recent TBCP and 100 patients with non-tuberculosis lung disease (NTBLD).
Using a defined level of specific IFN-gamma production and TST 10mm as positive cut-offs, the sensitivity of HGIA was 81% compared to 89% for TST (p=0.06). When positive responses in both TST and HGIA were combined, 96% of TB patients were detected. For the NTBLD group, 43% of whom were born overseas, 73% were negative for both the HGIA and TST. Prior immunization with M. bovis (bacille Calmette-Guerin) (BCG) or the type of TB had no effect on the sensitivities of the assays. For those treated for <2 months, the sensitivities for both assays were 84%, but for those treated for >2 months the sensitivity of TST (90%) tended to be higher than for HGIA (81%) (p=0.07). The distribution of TST results in TB patients showed a broad peak between 10 and 25 mm, while the results in the HGIA were bimodal in both TB and NTBLD patients.
HGIA may prove an alternative to skin testing for detecting M. tuberculosis infection in certain settings.
澳大利亚九家大学附属医院的胸部诊所。
评估全血人γ-干扰素检测法（HGIA，QuantiFERON-TB）对特异性T淋巴细胞反应的敏感性以及结核菌素皮肤试验（TST）对已通过培养证实患有结核分枝杆菌病（TBCP）的受试者中结核分枝杆菌感染的检测能力。
对129例近期患有TBCP的患者和100例非结核性肺病（NTBLD）患者进行前瞻性检测。
以特定的干扰素-γ产生水平和TST 10mm作为阳性临界值，HGIA的敏感性为81%，而TST为89%（p = 0.06）。当TST和HGIA的阳性反应相结合时，96%的结核病患者被检测出来。对于NTBLD组，其中43%出生在海外，73%的患者HGIA和TST均为阴性。既往接种过牛分枝杆菌（卡介苗）（BCG）或结核病类型对检测方法的敏感性没有影响。对于治疗时间<2个月的患者，两种检测方法的敏感性均为84%，但对于治疗时间>2个月的患者，TST的敏感性（90%）往往高于HGIA（81%）（p = 0.07）。结核病患者TST结果的分布在10至25mm之间呈现出一个较宽的峰值，而HGIA的结果在结核病患者和NTBLD患者中均为双峰分布。
在某些情况下，HGIA可能被证明是一种替代皮肤试验用于检测结核分枝杆菌感染的方法。
