Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) i...Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.展开更多
目的探讨结核分枝杆菌感染T细胞斑点试验（spot test of T cells infected with Mycobacterium tuberculosis,TSPOT.TB）评分在多系统结核感染诊断中的应用价值。方法回顾性纳入2013年10月至2014年9月在郑州大学第一附属医院住院并确诊...目的探讨结核分枝杆菌感染T细胞斑点试验（spot test of T cells infected with Mycobacterium tuberculosis,TSPOT.TB）评分在多系统结核感染诊断中的应用价值。方法回顾性纳入2013年10月至2014年9月在郑州大学第一附属医院住院并确诊为结核感染的530例患者,所有患者均应用T-SPOT.TB试剂盒检测。分别将外周血中经6 k D早期分泌靶抗原（early secretory antigenic target 6,ESAT-6）和10 k D培养滤过蛋白（culture filtrate protein 10,CFP-10）刺激后T细胞斑点形成数记为其A值、B值。根据病变侵及范围分为单系统结核感染组和多系统结核感染组,分析两组间阳性检出率及两组A值、B值的差异。结果 T-SPOT.TB诊断结核感染的总敏感性为87.7%（465/530）。多系统结核感染组的阳性检出率94.1%（143/152）高于单系统结核感染组的阳性检出率85.1%（322/378）。多系统感染组的A值（202.32±4.57）/10~6PBMCs及B值（207.20±4.98）/10~6PBMCs均显著高于单系统感染组的A值（35.51±2.38）/10~6PBMCs及B值（38.48±1.91）/10~6PBMCs,差异均具有统计学意义（t_A=5.33;t_B=4.48;P〈0.001）。结论 T-SPOT.TB在诊断单系统及多系统结核感染中具有较高的敏感性,其值越高,提示多系统结核感染的可能性越大。展开更多
文摘Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.
文摘目的探讨结核分枝杆菌感染T细胞斑点试验（spot test of T cells infected with Mycobacterium tuberculosis,TSPOT.TB）评分在多系统结核感染诊断中的应用价值。方法回顾性纳入2013年10月至2014年9月在郑州大学第一附属医院住院并确诊为结核感染的530例患者,所有患者均应用T-SPOT.TB试剂盒检测。分别将外周血中经6 k D早期分泌靶抗原（early secretory antigenic target 6,ESAT-6）和10 k D培养滤过蛋白（culture filtrate protein 10,CFP-10）刺激后T细胞斑点形成数记为其A值、B值。根据病变侵及范围分为单系统结核感染组和多系统结核感染组,分析两组间阳性检出率及两组A值、B值的差异。结果 T-SPOT.TB诊断结核感染的总敏感性为87.7%（465/530）。多系统结核感染组的阳性检出率94.1%（143/152）高于单系统结核感染组的阳性检出率85.1%（322/378）。多系统感染组的A值（202.32±4.57）/10~6PBMCs及B值（207.20±4.98）/10~6PBMCs均显著高于单系统感染组的A值（35.51±2.38）/10~6PBMCs及B值（38.48±1.91）/10~6PBMCs,差异均具有统计学意义（t_A=5.33;t_B=4.48;P〈0.001）。结论 T-SPOT.TB在诊断单系统及多系统结核感染中具有较高的敏感性,其值越高,提示多系统结核感染的可能性越大。
