Pan Liping, Jia Hongyan, Liu Fei, Gao Mengqiu, Sun Huishan, Du Boping, Sun Qi, Xing Aiying, Wei Rongrong, Zhang Zongde
Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China; Email:
Zhonghua Jie He He Hu Xi Za Zhi. 2015 Dec;38(12):892-6.
To evaluate the value of T-SPOT.TB assay in the diagnosis of pulmonary tuberculosis within different age groups.
We analyzed 1 518 suspected pulmonary tuberculosis (PTB) patients who were admitted to the Beijing Chest Hospital from November 2012 to February 2014 and had valid T-SPOT.TB tests before anti-tuberculosis therapy. The 599 microbiologically and/or histopathologically-confirmed PTB patients (16-89 years old, 388 males and 211 females) and 235 non-TB patients (14-85 years old, 144 males and 91 females) were enrolled for the analysis of diagnostic performance of T-SPOT.TB, while patients with uncertain diagnosis or diagnosis based on clinical impression (n=684) were excluded from the analysis. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB were analyzed according to the final diagnosis. Furthermore, the diagnostic performance of T-SPOT.TB assay in the younger patients (14-59 years old) and elderly patients (60-89 years old) were also analyzed respectively. Categorical variables were compared by Pearson's Chi-square test, while continuous variables were compared by the Mann-Whitney U-test.
The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB in diagnosis of PTB were 90.1% (540/599), 65.5% (154/235), 86.9% (540/621), 72.3% (154/213), 2.61, and 0.15, respectively. The sensitivity and specificity of T-SPOT.TB assay were 92.6% (375/405) and 75.6% (99/131), respectively in the younger patients, and 85.0% (165/194), 52.9% (55/104) respectively in the elderly patients. The sensitivity and specificity of T-SPOT.TB assay in the younger patients were significantly higher than those in the elderly patients (P<0.01), and the spot forming cells in the younger PTB patients were significantly higher than in the elderly PTB patients [300 (126, 666)/10(6) PBMCs vs. 258 (79, 621)/10(6) PBMCs, P=0.037].
T-SPOT.TB is a promising test in the diagnosis of younger patients (14-59 years old) with suspected PTB, but the diagnostic performance in elderly patients (60-89 years old) is relatively reduced.
评估T-SPOT.TB检测在不同年龄组肺结核诊断中的价值。
我们分析了2012年11月至2014年2月在北京胸科医院住院的1518例疑似肺结核（PTB）患者，这些患者在抗结核治疗前进行了有效的T-SPOT.TB检测。纳入599例经微生物学和/或组织病理学确诊的PTB患者（年龄16 - 89岁，男性388例，女性211例）和235例非结核患者（年龄14 - 85岁，男性144例，女性91例）进行T-SPOT.TB诊断性能分析，排除诊断不明确或基于临床印象诊断的患者（n = 684）。根据最终诊断分析T-SPOT.TB的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比和阴性似然比。此外，还分别分析了T-SPOT.TB检测在年轻患者（14 - 59岁）和老年患者（60 - 89岁）中的诊断性能。分类变量采用Pearson卡方检验进行比较，连续变量采用Mann-Whitney U检验进行比较。
T-SPOT.TB诊断PTB的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比和阴性似然比分别为90.1%（540/599）、65.5%（154/235）、86.9%（540/621）、72.3%（154/213）、2.61和0.15。T-SPOT.TB检测在年轻患者中的敏感性和特异性分别为92.6%（375/405）和75.6%（99/131），在老年患者中分别为8
