Lian Guoli, Du Fangxiong, Wu Hongyan, He Min, Liu Zhigang
Clin Lab. 2017 Apr 1;63(4):773-779. doi: 10.7754/Clin.Lab.2016.161007.
The enzyme-linked immunospot assay test (T-SPOT.TB) is effective for detecting TB, but there are still some persons with tuberculosis (TB) who have negative results. The aim of this study was to analyze the factors that contribute to false negative results in active TB patients.
We investigated the clinical trial and laboratory data of the active TB patients hospitalized in the First Affiliated Hospital of Xi'an Jiaotong University from May 2013 to November 2014.
In 556 active TB patients, 198 infected sites were pulmonary, 358 infected sites were extra pulmonary, and 13.85% (77/556) had false negative T SPOT.TB results. The univariate and multivariate analysis showed that age and bone/joint TB were the factors contributing to the T-SPOT. TB false negative results and pleural TB were related to true positive results.
The site of TB may significantly affect the sensitivity of T-SPOT.TB. False negative results of TSPOT.TB are associated with older age and bone/joint TB, so in older adult patients or those with bone/joint TB, the exclusion of TB should be regarded with caution when T-SPOT.TB results are negative.
酶联免疫斑点试验（T-SPOT.TB）对检测结核病有效，但仍有一些结核病患者检测结果为阴性。本研究旨在分析导致活动性结核病患者出现假阴性结果的因素。
我们调查了2013年5月至2014年11月在西安交通大学第一附属医院住院的活动性结核病患者的临床试验和实验室数据。
556例活动性结核病患者中，198个感染部位为肺部，358个感染部位为肺外，13.85%（77/556）的T-SPOT.TB结果为假阴性。单因素和多因素分析表明，年龄和骨/关节结核是导致T-SPOT.TB假阴性结果的因素，而胸膜结核与真阳性结果相关。
结核病的发病部位可能显著影响T-SPOT.TB的敏感性。T-SPOT.TB的假阴性结果与年龄较大和骨/关节结核有关，因此在老年成年患者或患有骨/关节结核的患者中，当T-SPOT.TB结果为阴性时，应谨慎排除结核病。
