The performance of the TBAg/PHA ratio in the diagnosis of active TB disease in immunocompromised patients
The performance of the TBAg/PHA ratio in the diagnosis of active TB disease in immunocompromised patients
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TBAg/PHA 比值在免疫功能低下患者活动性结核病诊断中的表现
DOI：
10.1016/j.ijid.2017.03.025
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发表时间：
2017-06-01
影响因子：
8.4
通讯作者：
Wang, Feng
中科院分区：
文献类型：
--
作者：
Bosco, Munyemana Jean;Hou, Hongyan;Wang, Feng
目的：T-SPOT的结果。在免疫功能低下的活动性肺结核(ATB)患者中，TB(T-Spot)检测结果降低，很难用T-Spot结果来区分这种情况下的ATB和潜在的结核病感染(LTBI)。方法：对143例免疫功能低下患者和12 4例LTBI患者进行常规检测和T-SPOT检测。结果：T-SPOT检测结果对免疫功能低下患者ATB的诊断无价值。然而，免疫低下的ATB患者在T-Spot检测中的植物血凝素(PHA)斑点形成细胞(SFC)数量显著低于LTBI患者。受试者工作特性(ROC)分析显示，进一步计算TBag/PHA比值(ESAT-6/PHA和CFP-10/PHA中较大者)对这两种疾病有较好的鉴别作用。以TBag/PHA的阈值为0.316，区分免疫低下的ATB患者和LTBI患者的敏感性和特异性分别为79.21%和94.05%。结论：TBag/PHA比值对免疫低下患者的结核病诊断有一定意义。(C)2017年作者。爱思唯尔有限公司代表国际传染病学会出版。
Objectives: The results of the T-SPOT. TB (T-SPOT) assay are reduced in immunocompromised patients with active tuberculosis (ATB), and it is difficult using T-SPOT results to distinguish ATB from latent tuberculosis infection (LTBI) in this condition. The aim of this study was to determine the performance of the TBAg/PHA ratio in T-SPOT assay in the diagnosis of ATB in immunocompromised patients.Methods: One hundred and forty three immunocompromised ATB patients and 124 LTBI individuals were diagnosed according to conventional tests and T-SPOT assay.Results: The results of T-SPOT assay are of no value in the diagnosis of ATB in immunocompromised patients. However, the number of phytohaemagglutinin (PHA) spot-forming cells (sfc) in T-SPOT assay was substantially decreased in immunocompromised ATB patients compared with that in LTBI individuals. Receiver operating characteristic (ROC) analysis revealed that a further calculation of the TBAg/ PHA ratio (the larger of the ESAT-6/PHA and CFP-10/PHA) showed a better performance in distinguishing these two diseases. Using the threshold value of 0.316, the sensitivity and specificity for distinguishing immunocompromised ATB patients from LTBI individuals were respectively 79.21 and 94.05%.Conclusions: Our findings suggest that the TBAg/PHA ratio might have some significance for the diagnosis of TB disease in immunocompromised patients. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.