Diagnostic value of T-SPOT.TB method in detection of pulmonary tuberculosis in patients receiving immuno-suppression

doi:10.3969/j.issn.1000-6621.2018.09.009

Abstract

Abstract:

Objective To explore the diagnostic value of T-SPOT.TB test in detection of pulmonary tuberculosis (PTB) among the patients receiving immuno-suppressive agents.Methods A total of 197 patients, who stayed at the inpatients department of Guangzhou Chest Hospital for receiving immunosuppressive agents treatment from Jul. 2013 to Dec. 2015 and were also diagnosed to be complicated with PTB, were enrolled in this study as the “Observation group”, while 200 PTB cases who stayed at the inpatients department of the same hospital at the same period were enrolled as the “Control group”. All enrolled patients were acid-fast bacillus (AFB) smear microscopy or culture positive with the specimens of their sputum or bronchoalveolar lavage fluid (BALF); in order to exclude NTB, the identification of Mycobacterium tuberculosis (MTB) was performed to culture positive isolates; the images of their chest X-rays were also consistent with the features of active PTB. The diagnosis of PTB for all enrolled patients was consistent with the standards of the Guideline for Pulmonary Tuberculosis Diagnosis and Treatment. The following test results (positive rate) between the two groups were compared: T-SPOT.TB test, AFB fluorescence stain microscopy of Auramine O, BACTEC MGIT 960 liquid culture (MGIT 960) and purified protein derivate (PPD) skin test. SPSS 19.0 software was used for calculation of χ ² test and P<0.05 was regarded as statistical significance. Results The positive rate of T-SPOT.TB was 85.28% (168/197) in the Observation group and 96.00% (192/200) in the Control group respectively; which was significantly higher than that of AFB fluorescence stain microscopy of Auramine O (36.55% (72/197) in the Observation group and 35.50% (71/200) in the Control group; χ ² was 98.24 in the Observation group and 162.53 in the Control group respectively (Ps=0.000)). The positive rates of T-SPOT.TB in the two groups were significantly higher than those of MGIT 960 culture (53.81% (106/197) in the Observation group and 57.50% (115/200) in the Control group; χ ² was 46.06 in the Observation group and 83.06 in the Control group respectively (P=0.000 in both groups). The positive rates of T-SPOT.TB test in both groups were significantly higher than those of PPD skin test (34.52% (68/197) in the Observation group and 63.50% (127/200) in the Control group; χ ² was 105.66 in the Observation group and 65.40 in the Control group respectively (P=0.000 in both groups)). The positive rates of T-SPOT.TB and PPD skin test in the Observation group were significantly lower than those in the Control group (the former χ ² was 13.50 (P=0.000) and the later χ ² was 33.36 (P=0.000)).Conclusion The positive rate of T-SPOT.TB test in those patients receiving immunosuppressive agents and are complicated with PTB is high. The T-SPOT.TB test, as an auxiliary diagnostic method of PTB, is more valuable than those traditional methods.

Key words: Tuberculosis, pulmonary, Immunosuppressive agents, Enzyme-linked immunospot assay, Laboratory techniques and procedures, Comparative study

Yi-gang TAN,Yan-hong LI,Min-li ZHENG. Diagnostic value of T-SPOT.TB method in detection of pulmonary tuberculosis in patients receiving immuno-suppression[J]. Chinese Journal of Antituberculosis, 2018, 40(9): 954-958. doi: 10.3969/j.issn.1000-6621.2018.09.009

Figures/Tables 1

References 18

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组别	T-SPOT.TB		金胺O涂片镜检		χ²值^a	P值^a	MGIT 960培养		χ²值^a	P值^a	PPD试验		χ²值^a	P值^a
组别	阳性	阴性	阳性	阴性	χ²值^a	P值^a	阳性	阴性	χ²值^a	P值^a	阳性	阴性	χ²值^a	P值^a
观察组 (197例)	168 (85.28)	29 (14.72)	72 (36.55)	125 (63.45)	98.24	0.000	106 (53.81)	91 (46.19)	46.06	0.000	68 (34.52)	129 (65.48)	105.66	0.000
对照组 (200例)	192 (96.00)	8 (4.00)	71 (35.50)	129 (64.50)	162.53	0.000	115 (57.50)	85 (42.50)	83.06	0.000	127 (63.50)	73 (36.50)	65.40	0.000
χ²值^b	13.50		0.05		-	-	0.55		-	-	33.36		-	-
P值^b	0.000		0.835		-	-	0.480		-	-	0.000		-	-