Clinical Evaluation of the T-SPOT.TB Test for Patients with Indeterminate Results on the QuantiFERON TB-2G Test
Clinical Evaluation of the T-SPOT.TB Test for Patients with Indeterminate Results on the QuantiFERON TB-2G Test
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DOI：
10.2169/internalmedicine.48.1432
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发表时间：
2009-01-01
影响因子：
1.2
通讯作者：
Oka, Mikio
中科院分区：
文献类型：
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作者：
Kobashi, Yoshihiro;Sugiu, Tadaaki;Oka, Mikio
目的评价T-SPOT的临床应用价值。材料与方法对378例临床怀疑活动性肺结核的患者进行QFT-2G试验，其中40例（10.6%）结果不确定。T-SPOT。结果40例患者（10.6%）在QFT-2G试验中因阳性对照IFN-γ水平较低而被判定为不确定结果。与QFT-2G试验结果确定的患者相比，在结果不确定的患者中，老年患者（68.2 vs 57.7）或接受免疫抑制治疗的免疫功能低下患者以及淋巴细胞计数、血清蛋白和白蛋白降低的患者更容易被识别。T-SPOT。40例QFT-2G试验结果不确定的患者中，26例（65.0%）TB试验结果明确，其中6例T-SPOT阳性，20例T-SPOT阴性。肺结核测试。老年患者（73.5比64.3）或患者的基础疾病，如恶性疾病和那些接受免疫抑制剂治疗和低营养条件的患者更频繁地认识到在患者中的不确定结果的患者相比，确定的结果在两个test.Conclusion我们认为可能有必要引入T-SPOT。T-SPOT可进一步降低QFT-2G试验的不确定性，从而提高结核病（包括潜伏性结核感染）的诊断率。肺结核测试。虽然14例患者在两项试验中均显示不确定的结果，但这些患者的淋巴细胞可能不具有功能性细胞因子产生活性。
Objective To evaluate the clinical utility of the T-SPOT. TB test for patients with indeterminate results on the QFT-2G test.Materials and Methods Forty patients (10.6%) showed indeterminate results among 378 patients who underwent QFT-2G test because active TB disease was clinically suspected. T-SPOT. TB test was performed for these 40 patients before the initiation of antituberculous treatment.Results Forty patients (10.6%) were judged as showing indeterminate results on QFT-2G test because the positive control presented a lower IFN-gamma level. Elderly patients (68.2 versus 57.7) or immunocompromised patients receiving immunosuppressive treatments and patients with a decrease in lymphocyte count, serum protein and albumin were more frequently recognized in the patients with indeterminate results compared to those with determinate results on QFT-2G test. T-SPOT. TB test could clearly demonstrate the results in 26 of the 40 patients (65.0%) with indeterminate results of QFT-2G test; these were divided into six patients with positive results and 20 with negative results of T-SPOT. TB test. Elderly patients (73.5 versus 64.3) or patients with underlying diseases such as malignant disease and those receiving immunosuppressive treatment and patients with hyponutritional conditions were more frequently recognized in the patients with indeterminate results compared to patients with determinate results on both tests.Conclusion We think it may be necessary to introduce T-SPOT. TB test to increase the diagnostic rate of TB disease including latent tuberculosis infection because indeterminate results of QFT-2G test might be further decreased using T-SPOT. TB test. Although 14 patients showed indeterminate results on both tests, the lymphocytes of these patients may not possess functional cytokine production activity.