Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan, 736.
Diagn Microbiol Infect Dis. 2011 Oct;71(2):139-43. doi: 10.1016/j.diagmicrobio.2011.05.013. Epub 2011 Aug 15.
The aim of this study was to compare the diagnostic performance of 2 interferon-γ release assays, an enzyme-linked immunospot assay (T-SPOT.TB; Oxford Immunotec Ltd., Oxford, UK) and the QuantiFERON-TB Gold in-Tube assay (QFT-GIT; Cellestis Ltd., Carnegie, Australia), in patients with suspected active tuberculosis (TB). From October 2009 to October 2011, a total of 200 patients with suspected TB were enrolled. Clinical and microbiological characteristics of the patients were collected and blood samples were obtained for T-SPOT.TB and QFT-GIT assays. Among the 200 subjects, 98 (49%) had culture-confirmed TB, 18 (9%) had probable TB, and the remaining 84 (42%) subjects did not have TB. The sensitivity, specificity, positive predictive value, and negative predictive value for active TB diagnosis by the T SPOT. TB were 83%, 71%, 81%, and 75%, respectively. For QFT-GIT, the sensitivity, specificity, positive predictive value, and negative predictive value for active TB diagnosis were 66%, 76%, 80%, and 62%, respectively. The QFT-GIT assay resulted in more indeterminate and false-negative results than the T-SPOT.TB assay, especially in immunocompromised patients. In conclusion, T-SPOT.TB had a higher sensitivity and resulted in fewer indeterminate results than the QFT-GIT assay for diagnosing active TB.
本研究旨在比较两种干扰素-γ释放检测方法,酶联免疫斑点法(T-SPOT.TB;英国牛津免疫技术公司,牛津)和结核感染 T 细胞检测(QuantiFERON-TB Gold in-Tube assay,QFT-GIT;澳大利亚细胞科技公司,卡内基)在疑似活动性结核病(TB)患者中的诊断性能。2009 年 10 月至 2011 年 10 月,共纳入 200 例疑似结核病患者。收集患者的临床和微生物学特征,并采集血样用于 T-SPOT.TB 和 QFT-GIT 检测。在 200 例患者中,98 例(49%)培养证实为结核病,18 例(9%)为可能的结核病,其余 84 例(42%)患者未患结核病。T-SPOT.TB 对活动性 TB 诊断的敏感性、特异性、阳性预测值和阴性预测值分别为 83%、71%、81%和 75%。对于 QFT-GIT,对活动性 TB 诊断的敏感性、特异性、阳性预测值和阴性预测值分别为 66%、76%、80%和 62%。与 T-SPOT.TB 检测相比,QFT-GIT 检测导致更多的不确定和假阴性结果,尤其是在免疫功能低下的患者中。总之,与 QFT-GIT 检测相比,T-SPOT.TB 检测对诊断活动性结核病的敏感性更高,且导致的不确定结果更少。