Naval Institute for Dental and Biomedical Research, Great Lakes, Illinois, USA.
Int J Tuberc Lung Dis. 2009 Nov;13(11):1416-21.
Great Lakes, Illinois, USA.
To compare the performance of an interferon-gamma release assay (T-SPOT.TB) and tuberculin skin test (TST) in a population with a low prevalence of tuberculosis (TB) that was predominantly US-born and not bacille Calmette-Guérin-vaccinated.
A total of 414 subjects with absence of a previous positive TST were enrolled, of whom 326 yielded analyzable results for both TST and T-SPOT.TB.
Overall agreement between T-SPOT.TB and TST was 98.2% (95%CI 96.0-99.3). The specificity of T-SPOT.TB in individuals judged to be at low risk for TB infection was 98.9% (95%CI 96.9-99.8). Of 326 subjects, 8 (2.5%) had a positive T-SPOT.TB result, six of which occurred in the absence of a positive TST. Of these, at least three appeared to have risk factors, suggesting the possibility of a false-negative TST result.
Because of the excellent agreement between the TSPOT.TB and the TST, either test can serve as an effective diagnostic tool in populations at low risk for TB. As the tests have specific advantages and disadvantages, health care providers have leeway in choosing the most appropriate test for the population they are treating.
美国伊利诺伊州五大湖地区。
比较干扰素 -γ释放试验（T-SPOT.TB）和结核菌素皮肤试验（TST）在以美国出生为主且未接种卡介苗的低结核患病率人群中的表现。
共纳入 414 例先前 TST 检测结果为阴性的受试者，其中 326 例 TST 和 T-SPOT.TB 检测结果均可分析。
T-SPOT.TB 与 TST 之间的总体一致性为 98.2%（95%CI 96.0-99.3）。在判断为结核病感染低风险的个体中，T-SPOT.TB 的特异性为 98.9%（95%CI 96.9-99.8）。326 例受试者中，8 例（2.5%）T-SPOT.TB 检测结果阳性，其中 6 例 TST 检测结果阴性。其中至少 3 例似乎存在危险因素，提示 TST 检测结果可能为假阴性。
由于 T-SPOT.TB 与 TST 之间具有极好的一致性，因此这两种检测方法都可以作为结核病低风险人群的有效诊断工具。由于这两种检测方法各有优缺点，因此医疗保健提供者在为其治疗的人群中选择最合适的检测方法时具有一定的回旋余地。
