Diagnosis Value and Its Influencing Factors of T-SPOT.TB for Active Tuberculosis_Chinese Journal of Evidence-Based Medicine

Authors：

 LUQing-chun ¹ ^# ,  TANGXiao-yan ¹ ^# , XIONGtian-yuan ² , HUANGJi-chong ² , YANGMin ¹ , TONGXiang ¹ ,  FANHong ¹

1. Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, China;

Corresponding author：

FANHong, Email: fanhongfan@qq.com

Keywords：

Active tuberculosis; T-SPOT.TB assay; Risk factor; Diaguosis

DOI：

10.7507/1672-2531.20140090

Video：

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Objective To explore the value of T-SPOT.TB test in the diagnosis of active tuberculosis and its influencing factors. Methods From July 2010 to November 2012, a total of 289 suspected active tuberculosis patients were enrolled in the study and underwent T-SPOT.TB test. All the patients enrolled were from West China Hospital of Sichuan University. The diagnostic value of T-SPOT.TB applied in determining active tuberculosis was then evaluated. Results According to the diagnostic criteria, 84 patients diagnosed with active tuberculosis were eligible for analysis and enrolled as a tuberculosis group, and 156 patients were enrolled as a control group. The sensitivity of T-SPOT.TB test was 83.3%, while the specificity was 80.1%. Both univariate and multivariate analyses showed the characteristics of patients such as general conditions (eg. age, sex) and basic diseases (eg. immunosuppression condition, malignant tumour) were not the risk factors of false-positive or false-negative result of T-SPOT.TB. Conclusion T-SPOT.TB test for the diagnosis of active tuberculosis has high sensitivity and specificity, with important value referred for diagnosing suspected active tuberculosis patients.

Citation： LUQing-chun, TANGXiao-yan, XIONGtian-yuan, HUANGJi-chong, YANGMin, TONGXiang, FANHong. Diagnosis Value and Its Influencing Factors of T-SPOT.TB for Active Tuberculosis. Chinese Journal of Evidence-Based Medicine, 2014, 14(5): 522-526. doi: 10.7507/1672-2531.20140090 Copy

1.	Diel R, Loddenkemper R, Meywald-Walter K, et al. Predictive value of a whole blood IFN-gamma assay for the development of active tuberculosis disease after recent infection with Mycobacterium tuberculosis. Am J Respir Crit Care Med, 2008, 177(10):1164-1170.
2.	张丽帆, 刘晓清. γ干扰素释放分析T-SPOT.TB诊断结核感染临床应用进展.中国医学科学院学报, 2009, 31(4):506-510.
3.	Baum GL, Wu JN, Hua SS, et al. Skin sensitivity to histolyn, spherulin, and PPD in the People's Republic of China. Chest, 1990, 97(6): 1356-1359.
4.	Brock I, Weldingh K, Lillebaek T, et al. Comparison of tuberculin skin test and new specific blood test in tuberculosis contacts. Am J Respir Crit Care Med, 2004, 170(1):65-69.
5.	Simsek H, Alpar S, Ucar N, et al. Comparison of tuberculin skin testing and T-SPOT.TB for diagnosis of latent and active tuberculosis. Jpn J Infect Dis, 2010, 63(2):99-102.
6.	Turtle L, Kemp T, Davies GR, et al. In routine UK hospital practice T-SPOT.TB is useful in some patients with a modest pre-test probability of active tuberculosis. Eur J Intern Med, 2012, 23(4):363-367.
7.	Feng Y, Diao N, Shao L, et al. Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis. PLoS One, 2012, 7(3):e32652.
8.	Lai CC, Tan CK, Lin SH, et al. Diagnostic performance of wholeblood interferon-gamma assay and enzyme-linked immunospot assay for active tuberculosis. Diagn Microbiol Infect Dis, 2011, 71(2): 139-143.
9.	Boyd AE, Ashcroft A, Lipman M, et al. Limited added value of TSPOT.TB blood test in diagnosing active TB:a prospective bayesian analysis. J Infect, 2011, 62(6):456-461.
10.	Kim SH, Choi SJ, Kim HB, et al. Diagnostic usefulness of a T-cell based assay for extrapulmonary tuberculosis. Arch Intern Med, 2007, 167(20):2255-2259.
11.	霍霏霏, 张丽帆, 刘晓清.评价γ干扰素释放分析T-SPOT.TB在肺外结核病诊断中的敏感性.中国医学科学院学报, 2009, 31(4): 449-452.
12.	Rangaka MX, Wilkinson KA, Glynn JR, et al. Predictive value of interferon-gamma release assays for incident active tuberculosis:a systematic review and meta-analysis. Lancet Infect Dis, 2012, 12(1): 45-55.
13.	Chee CB, Gan SH, Khinmar KW, et al. Comparison of sensitivities of two commercial gamma interferon release assays for pulmonary tuberculosis. J Clin Microbiol, 2008, 46(6):1935-1940.
14.	Lee JY, Choi HJ, Park IN, et al. Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection. Eur Respir J, 2006, 28(1):24-30.
15.	Behr MA, Wilson MA, Gill WP, et al. Comparative genomics of BCG vaccines by whole-genome DNA microarray. Science, 1999, 284(5419):1520-1523.
16.	Pai M. Alternatives to the tuberculin skin test:interferon-gamma assays in the diagnosis of mycobacterium tuberculosis infection. Indian J Med Microbiol, 2005, 23(3):151-158.
17.	Dai Y, Feng Y, Xu R, et al. Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis:an updated meta-analysis. Eur J Clin Microbiol Infect Dis, 2012, 31(11):3127-3137.
18.	Yu Y, Zhao X, Wang W, et al. Diagnostic performance of interferongamma releasing assay in HIV-infected patients in China. PLoS One, 2013, 8(8):e70957.
19.	Santin M, Munoz L, Rigau D. Interferon-gamma release assays for the diagnosis of tuberculosis and tuberculosis infection in HIVinfected adults:a systematic review and meta-analysis. PLoS One, 2012, 7(3):e32482.
20.	Kim HJ, Yoon HI, Park KU, et al. The impact of previous tuberculosis history on T-SPOT.TB(R) interferon-gamma release assay results. Int J Tuberc Lung Dis, 2011, 15(4):510-516.
21.	Lee YM, Park KH, Kim SM, et al. Risk factors for false-negative results of T-SPOT.TB and tuberculin skin test in extrapulmonary tuberculosis. Infection, 2013, 41(6):1089-1095.

1. Diel R, Loddenkemper R, Meywald-Walter K, et al. Predictive value of a whole blood IFN-gamma assay for the development of active tuberculosis disease after recent infection with Mycobacterium tuberculosis. Am J Respir Crit Care Med, 2008, 177(10):1164-1170.
2. 张丽帆, 刘晓清. γ干扰素释放分析T-SPOT.TB诊断结核感染临床应用进展.中国医学科学院学报, 2009, 31(4):506-510.
3. Baum GL, Wu JN, Hua SS, et al. Skin sensitivity to histolyn, spherulin, and PPD in the People's Republic of China. Chest, 1990, 97(6): 1356-1359.
4. Brock I, Weldingh K, Lillebaek T, et al. Comparison of tuberculin skin test and new specific blood test in tuberculosis contacts. Am J Respir Crit Care Med, 2004, 170(1):65-69.
5. Simsek H, Alpar S, Ucar N, et al. Comparison of tuberculin skin testing and T-SPOT.TB for diagnosis of latent and active tuberculosis. Jpn J Infect Dis, 2010, 63(2):99-102.
6. Turtle L, Kemp T, Davies GR, et al. In routine UK hospital practice T-SPOT.TB is useful in some patients with a modest pre-test probability of active tuberculosis. Eur J Intern Med, 2012, 23(4):363-367.
7. Feng Y, Diao N, Shao L, et al. Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis. PLoS One, 2012, 7(3):e32652.
8. Lai CC, Tan CK, Lin SH, et al. Diagnostic performance of wholeblood interferon-gamma assay and enzyme-linked immunospot assay for active tuberculosis. Diagn Microbiol Infect Dis, 2011, 71(2): 139-143.
9. Boyd AE, Ashcroft A, Lipman M, et al. Limited added value of TSPOT.TB blood test in diagnosing active TB:a prospective bayesian analysis. J Infect, 2011, 62(6):456-461.
10. Kim SH, Choi SJ, Kim HB, et al. Diagnostic usefulness of a T-cell based assay for extrapulmonary tuberculosis. Arch Intern Med, 2007, 167(20):2255-2259.
11. 霍霏霏, 张丽帆, 刘晓清.评价γ干扰素释放分析T-SPOT.TB在肺外结核病诊断中的敏感性.中国医学科学院学报, 2009, 31(4): 449-452.
12. Rangaka MX, Wilkinson KA, Glynn JR, et al. Predictive value of interferon-gamma release assays for incident active tuberculosis:a systematic review and meta-analysis. Lancet Infect Dis, 2012, 12(1): 45-55.
13. Chee CB, Gan SH, Khinmar KW, et al. Comparison of sensitivities of two commercial gamma interferon release assays for pulmonary tuberculosis. J Clin Microbiol, 2008, 46(6):1935-1940.
14. Lee JY, Choi HJ, Park IN, et al. Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection. Eur Respir J, 2006, 28(1):24-30.
15. Behr MA, Wilson MA, Gill WP, et al. Comparative genomics of BCG vaccines by whole-genome DNA microarray. Science, 1999, 284(5419):1520-1523.
16. Pai M. Alternatives to the tuberculin skin test:interferon-gamma assays in the diagnosis of mycobacterium tuberculosis infection. Indian J Med Microbiol, 2005, 23(3):151-158.
17. Dai Y, Feng Y, Xu R, et al. Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis:an updated meta-analysis. Eur J Clin Microbiol Infect Dis, 2012, 31(11):3127-3137.
18. Yu Y, Zhao X, Wang W, et al. Diagnostic performance of interferongamma releasing assay in HIV-infected patients in China. PLoS One, 2013, 8(8):e70957.
19. Santin M, Munoz L, Rigau D. Interferon-gamma release assays for the diagnosis of tuberculosis and tuberculosis infection in HIVinfected adults:a systematic review and meta-analysis. PLoS One, 2012, 7(3):e32482.
20. Kim HJ, Yoon HI, Park KU, et al. The impact of previous tuberculosis history on T-SPOT.TB(R) interferon-gamma release assay results. Int J Tuberc Lung Dis, 2011, 15(4):510-516.
21. Lee YM, Park KH, Kim SM, et al. Risk factors for false-negative results of T-SPOT.TB and tuberculin skin test in extrapulmonary tuberculosis. Infection, 2013, 41(6):1089-1095.

Chinese Journal of Evidence-Based Medicine

Diagnosis Value and Its Influencing Factors of T-SPOT.TB for Active Tuberculosis

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