γ-干扰素释放试验、QuantiFERON TB-GIT和T-SPOT.TB在类风湿关节炎中的比较效用

Comparative utility of interferon-γ release assay, QuantiFERON TB-GIT and T-SPOT.TB in rheumatoid arthritis.

作者信息

Matsumura R, Igari H, Nakazawa T, Ishikawa S, Tsuyuzaki M, Suzuki K, Yamagishi F

机构信息

Center of Rheumatology, Allergy & Clinical Immunology, National Hospital Organization Chiba-East Hospital, Chiba, Japan.

Department of Respiratory Medicine, National Hospital Organization Chiba-East Hospital, Chiba, Division of Infection Control, Chiba University Hospital, Chiba, Japan.

出版信息

Int J Tuberc Lung Dis. 2016 Nov;20(11):1546-1553. doi: 10.5588/ijtld.16.0038.

DOI:10.5588/ijtld.16.0038

PMID:27776599

Abstract

SETTING

National hospital for tuberculosis (TB) and rheumatoid arthritis (RA) in Japan.

OBJECTIVE

To compare two interferon-γ release assays (IGRAs), QuantiFERON-TB Gold In-Tube (QFT) and T-SPOT.TB (T-SPOT), in RA patients for detecting latent tuberculous infection (LTBI).

DESIGN

QFT and T-SPOT were conducted concurrently in 230 prospectively enrolled RA patients.

RESULTS

There were no active TB patients. The percentage of QFT- and T-SPOT-positive patients was respectively 8.3% and 5.7%. In patients aged ⩾60 years, these proportions were respectively 12.3% and 7.2%. The percentage of QFT positivity and T-SPOT positivity at age <60 years was respectively 2.2% and 3.3%. After multivariate logistic analysis for QFT positivity, age ⩾60 years and TB suspected based on chest X-ray were selected as independent factors, with adjusted odds ratios of respectively 4.73 and 3.25. No factors were selected for T-SPOT positivity.

CONCLUSION

QFT had a higher positivity rate. In the light of the previous estimated rate of LTBI in Japan, both IGRAs underestimate LTBI, and neither IGRA has enough capability to detect LTBI.

摘要

背景

日本国立结核病与类风湿关节炎医院。

目的

比较两种干扰素-γ释放检测法（IGRAs），即管内定量结核菌素试验（QFT）和结核感染T细胞检测（T-SPOT.TB），在类风湿关节炎（RA）患者中检测潜伏性结核感染（LTBI）的情况。

设计

对230例前瞻性纳入的RA患者同时进行QFT和T-SPOT检测。

结果

无活动性结核患者。QFT阳性患者百分比和T-SPOT阳性患者百分比分别为8.3%和5.7%。在年龄≥60岁的患者中，这些比例分别为12.3%和7.2%。年龄<60岁时QFT阳性百分比和T-SPOT阳性百分比分别为2.2%和3.3%。对QFT阳性进行多因素逻辑回归分析后，年龄≥60岁和基于胸部X线怀疑结核被选为独立因素，调整后的比值比分别为4.73和3.25。未选出与T-SPOT阳性相关的因素。