期刊
TUBERCULOSIS AND RESPIRATORY DISEASES
卷 73, 期 3, 页码 143-150出版社
TAEHAN KYORHAEK HYOPHOE-KOREAN ACAD TUBERCULOSIS & RESPIRATORY DISEASES
DOI: 10.4046/trd.2012.73.3.143
关键词
Interferon-gamma Release Tests; Tuberculosis; Pleural
资金
- Catholic Research Coordinating Center of the Korea Health 21 RD Project [A070001]
- Ministry of Health & Welfare, Republic of Korea
Background: The release of interferon-gamma (IFN-gamma) by T lymphocytes increases after rechallenge with Mycobacterium tuberculosis antigen, especially, at a localized site of tuberculosis (TB) infection. We aimed to compare the clincial efficacy of two commercial IFN-gamma release assays from pleural fluid for the diagnosis in tuberculous pleurisy. Methods: We performed T-SPOT. TB and QuantiFERON-TB Gold tests simultaneously on pleural fluid and peripheral blood samples from patients with pleural effusion, in South Korea, an area with intermediate TB burden. Results: Thirty-six patients were enrolled prospectively, and tuberculous pleurisy was found in 21 patients. Both the numbers of IFN-gamma secreting T cells and the concentration of IFN-gamma were greater in the pleural tuberculous group, comparing with the non-tuberculous group. Moreover, in the tuberculous group, there was a significant difference in IFN-gamma producing spot-forming cells using the T-SPOT.TB method between pleural fluid and peripheral blood. The receiver operating characteristic (ROC) curve, was the greatest for pleural fluid T-SPOT. TB test, followed by peripheral blood T-SPOT. TB test, peripheral blood QuantiFERON-TB Gold test, and pleural fluid QuantiFERON-TB Gold test (area under the ROC curve of 0.956, 0.890, 0.743, and 0.721, respectively). The T-SPOT. TB assay produced less indeterminate results than did QuantiFERON-TB Gold assay in both pleural fluid and peripheral blood. Conclusion: These findings suggest that the pleural fluid T-SPOT.TB test could be the most useful test among the IFN-gamma release assays for diagnosing tuberculous pleurisy in an area with an intermediate prevalence of TB infection.
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