Ang Marcus, Kiew Sieh Yean, Wong Wan Ling, Chee Soon-Phaik
Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, Yong Yoo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Singapore National Eye Centre, Singapore, Singapore.
Br J Ophthalmol. 2014 Dec;98(12):1649-53. doi: 10.1136/bjophthalmol-2014-305229. Epub 2014 Jul 7.
To describe interferon-γ release assay (IGRA) and IGRA/tuberculin skin test (TST) discordance and their associated factors in patients with uveitis.
Prospective study of 102 consecutive new patients presenting with uveitis to a tertiary referral centre. All patients underwent a complete ocular and systemic examination at presentation, with QuantiFERON-Gold in-tube (QFT), T-SPOT.TB and TST performed. Discordant results of TST/QFT, TST/T-SPOT.TB and QFT/T-SPOT.TB were analysed. Binary logistic regression was used to identify factors associated with discordant results.
There was fair agreement between TST and T-SPOT.TB (κ=0.371, p<0.001); moderate agreement between TST and QFT (κ=0.471, p<0.001). Both IGRAs showed good agreement (κ=0.668, p<0.001). The discordance rate between the TST/QFT was 26.5%, while TST/T-SPOT.TB was 31.4%. The discordance rate between the IGRAs was 16.7%. There was a significant association between TST/IGRA discordance with increasing age (OR 0.95, 95% CI 0.92 to 0.99; p=0.022), less likely with panuveitis (OR 0.18, 95% CI 0.04 to 0.86; p=0.032), and with Indian ethnicity (OR 14.07, 95% CI 1.45 to 137.03; p=0.023).
Discordance of IGRA and TST results is common and requires further study. In our study in patients with uveitis, we found that ethnicity, age, and type of uveitis were some significant factors associated with TST/IGRA discordance, which may need to be taken into consideration when interpreting these results.
描述葡萄膜炎患者中干扰素-γ释放试验（IGRA）和IGRA/结核菌素皮肤试验（TST）结果不一致的情况及其相关因素。
对一家三级转诊中心连续收治的102例新发葡萄膜炎患者进行前瞻性研究。所有患者在就诊时均接受了全面的眼部和全身检查，并进行了全血干扰素-γ释放试验（QFT）、结核感染T细胞检测（T-SPOT.TB）和TST。分析了TST/QFT、TST/T-SPOT.TB和QFT/T-SPOT.TB结果不一致的情况。采用二元逻辑回归分析确定与结果不一致相关的因素。
TST与T-SPOT.TB之间一致性一般（κ=0.371，p<0.001）；TST与QFT之间一致性中等（κ=0.471，p<0.001）。两种IGRA之间显示出良好的一致性（κ=0.668，p<0.001）。TST/QFT之间的不一致率为26.5%，而TST/T-SPOT.TB为31.4%。两种IGRA之间的不一致率为16.7%。TST/IGRA结果不一致与年龄增加显著相关（比值比0.95，95%可信区间0.92至0.
