Kobashi Yoshihiro, Mouri Keiji, Yagi Shinichi, Obase Yasushi, Miyashita Naoyuki, Oka Mikio
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan.
Respirology. 2009 Mar;14(2):276-81. doi: 10.1111/j.1440-1843.2008.01443.x. Epub 2008 Dec 11.
The aim of this study was to evaluate the QuantiFERON TB-2G (QFT-2G) results in patients with active extrapulmonary tuberculosis (E-TB) to determine whether QFT-2G test might be a reliable diagnostic method for detecting active E-TB infection compared with the tuberculin skin test (TST).
TST and QFT-2G tests were performed for 35 patients with confirmed E-TB, 30 with probable E-TB and 45 who did not have E-TB.
For patients with confirmed E-TB, the positive rate of the TST was 57% and that of the QFT-2G test was 86%. For patients with probable E-TB, the positive rate of the TST was 60%, whereas that of the QFT-2G test was 80%. However, the positive rate of the TST was 51% and that of QFT-2G test was 9% for patients that did not have E-TB. The QFT-2G test showed a significantly lower percentage of false-negative results compared with the TST. The sensitivity and specificity of the TST for the diagnosis of active E-TB were 57% and 49%, respectively. By comparison, the sensitivity and specificity of the QFT-2G test were 86% and 84%, respectively. When the results of the TST and QFT-2G tests were separated by the site of E-TB, the positive rates for both tests in patients with miliary tuberculosis were lower than those in patients with other E-TB disease, although the difference was not significant.
The QFT-2G appears to be a reliable diagnostic test and in the appropriate clinical context QFT-2G may be more useful than the TST to support a diagnosis of E-TB. Studies are needed to evaluate its value also in situations of low clinical probability.
本研究旨在评估结核感染T细胞检测-2G（QFT-2G）在肺外活动性结核（E-TB）患者中的检测结果，以确定与结核菌素皮肤试验（TST）相比，QFT-2G检测是否可能是检测活动性E-TB感染的可靠诊断方法。
对35例确诊E-TB患者、30例疑似E-TB患者和45例无E-TB患者进行TST和QFT-2G检测。
确诊E-TB患者中，TST阳性率为57%，QFT-2G检测阳性率为86%。疑似E-TB患者中，TST阳性率为60%，而QFT-2G检测阳性率为80%。然而，无E-TB患者中，TST阳性率为51%，QFT-2G检测阳性率为9%。与TST相比，QFT-2G检测的假阴性结果百分比显著更低。TST诊断活动性E-TB的敏感性和特异性分别为57%和49%。相比之下，QFT-2G检测的敏感性和特异性分别为86%和84%。当按E-TB部位区分TST和QFT-2G检测结果时，粟粒性结核患者中两种检测的阳性率均低于其他E-TB疾病患者，尽管差异不显著。
QFT-2G似乎是一种可靠的诊断检测方法，在适当的临床背景下，QFT-2G可能比TST更有助于支持E-TB的诊断。还需要开展研究以评估其在临床可能性较低情况下的价值。
