Ariga Haruyuki, Nagai Hideaki, Kurashima Atsuyuki, Hoshino Yoshihiko, Shoji Syunsuke, Nakajima Yutsuki
Center for Respiratory Medicine, National Hospital Organization, Tokyo National Hospital, 3-1-1 Takeoka, Kiyose, Tokyo 204-8585, Japan.
Tuberc Res Treat. 2011;2011:940642. doi: 10.1155/2011/940642. Epub 2011 Jun 27.
Background. The detection of latent tuberculosis (TB) is essential for TB control, but T-cell assay might be influenced by degree of immunosuppression. The relationship between immunocompetence and interferon (IFN)-γ response in QuantiFERON-TB Gold (QFT) is uncertain, especially in HIV-negative populations. Methods and Results. QFT has been performed for healthy subjects and TB suspected patients. Of 3017 patients, 727 were diagnosed as pulmonary TB by culture. The absolute number of blood lymphocyte in TB patients was significantly associated with QFT. Definitive TB patients were divided into eight groups according to lymphocyte counts. For each subgroup, receiver operating characteristic curve analysis was conducted from 357 healthy control subjects. The optimal cut-off for the patient group with adequate lymphocyte counts was found, but this was reduced for lymphocytopenia. Conclusions. The lymphocyte count was positively associated with QFT. Positive criteria should be calibrated in consideration of cell-mediated immunocompetence and risk of progression to active TB.
背景。潜伏性结核病（TB）的检测对结核病控制至关重要，但T细胞检测可能会受到免疫抑制程度的影响。在结核感染T细胞检测（QFT）中，免疫能力与干扰素（IFN）-γ反应之间的关系尚不确定，尤其是在HIV阴性人群中。方法与结果。对健康受试者和疑似结核病患者进行了QFT检测。在3017例患者中，727例经培养诊断为肺结核。结核病患者的血液淋巴细胞绝对数与QFT显著相关。确诊的结核病患者根据淋巴细胞计数分为八组。对每个亚组，从357名健康对照受试者进行了受试者操作特征曲线分析。发现淋巴细胞计数充足的患者组的最佳临界值，但淋巴细胞减少时该临界值降低。结论。淋巴细胞计数与QFT呈正相关。应根据细胞介导的免疫能力和进展为活动性结核病的风险校准阳性标准。
