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γ-干扰素释放试验在活动性结核病诊断中的临床价值

Clinical value of interferon-γ release assay in the diagnosis of active tuberculosis.

作者信息

Ai Lu, Feng Pinning, Chen Dubo, Chen Shaoqian, Xu Hongxu

机构信息

Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.

出版信息

Exp Ther Med. 2019 Aug;18(2):1253-1257. doi: 10.3892/etm.2019.7696. Epub 2019 Jun 21.

Abstract

Sensitivity and specificity of the interferon-γ release test for active tuberculosis screening were evaluated. Due to the high-test cost of imported IGRAs, QFT-GIT and T-SPOT.TB, we applied a cheaper domestic TB-IGRA which was approved in China recently. We recruited 740 patients and performed tuberculosis interferon release test (IGRAs), detection of IgG antibody (TB-IgG) and tuberculin skin test (TST). The sensitivity of the three methods are 90.8, 40.0 and 75.45%, with specificity of 76.62, 74.47 and 72.27%. The area under the ROC curve according to the value of T-N detected by IGRAs was 0.878 (95% CI, 0.839-0.917), with the area under the curve for the diagnosis of active pulmonary tuberculosis and extrapulmonary tuberculosis being 0.839 and 0.841 respectively. The interferon-γ release test seems to be superior to TST and TB-IgG as a screening tool for the detection of active tuberculosis in China.

摘要

评估了干扰素-γ释放试验用于活动性结核病筛查的敏感性和特异性。由于进口的IGRAs(QFT-GIT和T-SPOT.TB)检测成本高昂,我们应用了一种近期在中国获批的较便宜的国产结核IGRA。我们招募了740名患者,进行了结核干扰素释放试验(IGRAs)、IgG抗体检测(TB-IgG)和结核菌素皮肤试验(TST)。三种方法的敏感性分别为90.8%、40.0%和75.45%,特异性分别为76.62%、74.47%和72.27%。根据IGRAs检测的T-N值绘制的ROC曲线下面积为0.878(95%CI,0.839 - 0.917),用于诊断活动性肺结核和肺外结核的曲线下面积分别为0.839和0.841。在中国,干扰素-γ释放试验作为检测活动性结核病的筛查工具似乎优于TST和TB-IgG。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efd4/6614736/26da193eeb67/etm-18-02-1253-g00.jpg

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