Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
Department of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
Sci Rep. 2023 Jul 24;13(1):11963. doi: 10.1038/s41598-023-38900-5.
Interferon-γ release assay (IGRA) is a widely used blood test for detecting TB infection. However, a positive result of IGRA cannot differentiate active tuberculosis (ATB) infection from inactive tuberculosis (IATB). In this study, we established a nomogram model for predictive risk of ATB, differentiated from IATB, based on the concentration of interferon-γ (IFN-γ) of QuantiFERON-TB Gold In-Tube Test (QFT-GIT) and clinical characteristics. Participants with a positive QFT-GIT result were recruited and divided into a training and validation cohort according to hospitalisation date. The nomogram model for the differential diagnosis of ATB from IATB was established according to gender, age, pleural effusion (PE), and the concentration of IFN-γ in the Nil, TB antigen, and mitogen tube of QFT-GIT in the training cohort by logistic regression and validated in the validation cohort, and then combined with adenosine deaminase (ADA) to evaluated the performance value in ATB cases with PE. The area under receiver operating characteristic curve (AUC) of the diagnostic nomogram model, which we called the NSMC-ATB model for ATB diagnosis was 0.819 (95% CI 0.797-0.841), with sensitivity 73.16% and specificity 75.95% in training cohort, and AUC was 0.785 (95% CI 0.744-0.827), with sensitivity 67.44% and specificity 75.14% in validation cohort. A combination of the NSMC-ATB model and ADA performed better than the NSMC-ATB model and ADA alone in predicting ATB cases with PE, as AUC was 0.903 (95% CI 0.856-0.950) with sensitivity 78.63% and specificity 87.50%. We established an effective diagnostic nomogram model, called the NSMC-ATB model to differentiate ATB from IATB. Meanwhile, the combination of the NSMC-ATB model and ADA improved the performance value of ATB with PE.
干扰素-γ 释放试验（IGRA）是一种广泛用于检测结核感染的血液检测方法。然而，IGRA 的阳性结果不能区分活动性结核病（ATB）感染和潜伏性结核病（IATB）。在这项研究中，我们基于 QuantiFERON-TB Gold In-Tube Test（QFT-GIT）的干扰素-γ（IFN-γ）浓度和临床特征，建立了一个预测 ATB 风险的列线图模型，以将其与 IATB 区分开来。招募了 QFT-GIT 阳性结果的参与者，并根据住院日期将其分为训练队列和验证队列。根据性别、年龄、胸腔积液（PE）和 QFT-GIT 的 IFN-γ 浓度，在训练队列中通过逻辑回归建立了用于区分 ATB 与 IATB 的列线图模型，并在验证队列中进行验证，然后与腺苷脱氨酶（ADA）结合，评估其在伴有 PE 的 ATB 病例中的性能值。我们称之为用于 ATB 诊断的 NSMC-ATB 模型的诊断列线图模型的受试者工作特征曲线（AUC）的面积为 0.819（95%CI 0.797-0.841），在训练队列中的敏感性为 73.16%，特异性为 75.95%，在验证队列中的 AUC 为 0.785（95%CI 0.744-0.827），敏感性为 67.44%，特异性为 75.14%。NSMC-ATB 模型与 ADA 联合使用在预测伴有 PE 的 ATB 病例方面优于 NSMC-ATB 模型和 ADA 单独使用，AUC 为 0.903（95%CI 0.856-0.950），敏感性为 78.63%，特异性为 87.50%。我们建立了一个有效的诊断列线图模型，称为 NSMC-ATB 模型，用于区分 ATB 和 IATB。同时，NSMC-ATB 模型与 ADA 的联合使用提高了伴有 PE 的 ATB 的性能值。
