Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis.
Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis.
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DOI：
10.1371/journal.pone.0032652
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Feng Y;Diao N;Shao L;Wu J;Zhang S;Jin J;Wang F;Weng X;Zhang Y;Zhang W
结核病的诊断仍然很困难。本研究旨在评估干扰素γ释放试验（IGRA）在诊断伴有肺和肺外累及的活动性结核病（ATB）中的表现，并确定IGRA （T-SPOT.TB）和结核菌素皮肤试验（TST）在bcg接种人群中的诊断作用。招募了226名ATB嫌疑人并对其进行了T-SPOT.TB检查。其中52例和76例受试者同时用5TU或1TU纯化蛋白衍生物（PPD）进行TST检测。T-SPOT的灵敏度。TB为94.7%(71/75)，肺和肺外疾病组具有可比性（95.6% vs. 93.3%, P b> 0.05），特异性为84.10%(90/107)，但两组差异较大（69.2% vs. 88.9%, P = 0.02）。与T-SPOT相比。TB、TST合并5TU-PPD的敏感性（92.3%比56.4%）和特异性（84.6%比61.5%）较低（P均<0.01）；TST合并1TU-PPD的敏感性为27.8%，尽管其特异性与T-SPOT相同。结核（均为82.8%）阳性预测值（PPV）仅为33.3%。通过结合T-SPOT。结核伴TST (1TU)，特异性上升至95%，但PPV保持不变。IGRA可作为一种强有力的免疫诊断试验来发现肺结核和肺外结核，而TST在识别bcg接种人群的结核病和感染方面未能发挥可靠或辅助作用。
The diagnosis of tuberculosis remains difficult. This study aimed to assess performance of interferon-gamma release assay (IGRA) in diagnosis of active tuberculosis (ATB) with pulmonary and extrapulmonary involvements, and to determine the diagnostic role of IGRA (T-SPOT.TB) and tuberculin skin test (TST) in BCG-vaccinated population. Two hundred twenty-six ATB suspects were recruited and examined with T-SPOT.TB. Among them, fifty-two and seventy-six subjects were simultaneously tested by TST with 5TU or 1TU of purified protein derivative (PPD). The sensitivity of T-SPOT.TB was 94.7% (71/75), comparable in pulmonary and extrapulmonary disease groups (95.6% vs. 93.3%, P>0.05), while the specificity was 84.10% (90/107) but differed in two groups (69.2% vs. 88.9%, P = 0.02). Compared to T-SPOT.TB, TST with 5TU-PPD showed less sensitivity (92.3% vs. 56.4%) and specificity (84.6% vs. 61.5%) (both P<0.01); the sensitivity of TST with 1TU-PPD was 27.8%, and despite its specificity identical to T-SPOT.TB (both 82.8%) positive predictive value (PPV) was only 33.3%. By combining T-SPOT.TB with TST (1TU), the specificity rose to 95%, but the PPV stayed unchanged. IGRA could function as a powerful immunodiagnostic test to explore pulmonary and extrapulmonary TB, while TST failed to play a reliable or auxiliary role in identifying TB disease and infection in the BCG-vaccinated population.
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DOI：
10.1164/rccm.200402-179oc
发表时间：
2004-07-01
影响因子：
24.7
作者：
Mori, T;Sakatani, M;Tsuyuguchi, I
通讯作者：
Tsuyuguchi, I
影响因子：
5.8
作者：
Jiang, Xin;Lu, Chanyi;Zhang, Ying
通讯作者：
Zhang, Ying
影响因子：
5.8
作者：
Sun, Y.;Zhang, Y.;Bao, L.
通讯作者：
Bao, L.
影响因子：
39.2
作者：
Menzies, Dick;Pai, Madhukar;Comstock, George
通讯作者：
Comstock, George
影响因子：
5.2
作者：
Siu, Gilman Kit Hang;Zhang, Ying;Yam, Wing-Cheong
通讯作者：
Yam, Wing-Cheong