Meta-analysis of T-SPOT.TB test for diagnosing spinal tuberculosis

doi:10.3969/j.issn.1000-6621.2019.10.004

Abstract

Abstract:

Objective To systematically review the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis.Methods All literatures involved the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis which published from establishment to June 2019 were identified from CNKI, WanFang Data, VIP, PubMed, EMBASE, Cochrane Library, etc. Two researchers independently conducted literature search, screened the literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. MetaDisc 1.4 were used to conduct the meta-analysis.Results A total of 219 articles were retrieved and 8 articles were eventually included based on inclusion and exclusion criteria. The cumulative sensitivity of peripheral blood T-SPOT.TB test for the diagnosis of spinal tuberculosis was 88.0% (95%CI: 85.0% to 91.0%), and the specificity (SPE) was 90.0% (95%CI:86.0%-93.0%), the positive likelihood ratio (PLR) was 8.67 (95%CI:6.47-11.62), the negative likelihood ratio (NLR) was 0.13 (95%CI:0.10-0.16),the diagnosis odds ratio (OR) was 63.14 (95%CI:42.14-94.60), and the area under the curve (AUC) of summary receiver operating characteristics (SROC) was 0.95.Conclusion T-SPOT.TB test of peripheral blood plays a valuable role in the diagnosis of spinal tuberculosis and can be used as an effective method for rapid diagnosis of spinal tuberculosis.

Key words: Tuberculosis, spinal, Enzyme-linked immunospot assay, Diagnosis, Meta-analysis, Interferon gamma release assay

Li YAO,Jian SHENG,Bing WANG,Xi-yong DAI. Meta-analysis of T-SPOT.TB test for diagnosing spinal tuberculosis[J]. Chinese Journal of Antituberculosis, 2019, 41(10): 1084-1089. doi: 10.3969/j.issn.1000-6621.2019.10.004

Figures/Tables 8

References 24

[1]	Rajasekaran S, Soundararajan DCR, Shetty AP , et al. Spinal Tuberculosis: Current Concepts. Global Spine J, 2018,8(4 Suppl):96S-108S.
[2]	刘红, 黄永杰, 王静 , 等. 结核感染T细胞斑点试验在疑似结核病患者诊断中的价值研究. 中华结核和呼吸杂志, 2014,37(3):192-196. doi: 10.3760/cma.j.issn.1001-0939.2014.03.010
[3]	Nagashima H, Yamane K, Nishi T , et al. Recent trends in spinal infections: retrospective analysis of patients treated during the past 50 years. Int Orthop, 2010,34(3):395-399.
[4]	Whiting P, Rutjes AW, Reitsma JB , et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003,3:25.
[5]	Yuan K, Zhong Z, Zhang Q , et al. Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radio-graphic presentation) in China. Braz J Infect Dis, 2013,17(5):529-537.
[6]	李宝田, 焦云龙, 孙文星 . T-SPOT.TB检测在脊柱结核诊断中的应用. 中国骨科临床与基础研究杂志, 2015,7(2):74-78.
[7]	汪锴, 张小舟, 康嗣如 , 等. T-SPOT.TB检测在脊柱结核诊断及疗效评估中的价值. 检验医学与临床, 2018,15(19):2909-2912.
[8]	杨雪梅, 陈俊林, 顾德林 . 结核感染T细胞斑点试验对脊柱结核的辅助诊断价值. 交通医学, 2018,32(1):60-62.
[9]	刘汉辉, 李辉, 余嘉洪 . 结核感染T细胞斑点试验对脊柱结核的诊断价值. 中国骨科临床与基础研究杂志, 2017,9(6):355-359.
[10]	地里下提, 古甫丁, 马良 . 结核感染T细胞斑点试验在脊柱结核诊断中的应用. 脊柱外科杂志, 2014,12(6):357-359. doi: 10.3969/j.issn.1672-2957.2014.06.009
[11]	华裕忠, 程绍云, 姜国红 , 等. 结核菌感染T细胞干扰素释放检测在脊柱结核快速诊断中的应用. 中华医学杂志, 2016,96(27):2179-2181.
[12]	程红燕, 王东萍, 包训迪 , 等. 酶联免疫斑点试验在脊柱结核辅助诊断中的应用价值. 结核病与肺部健康杂志, 2017,6(4):372-376.
[13]	Trecarichi EM, Di Meco E, Mazzotta V , et al. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment,outcome. Eur Rev Med Pharmacol Sci, 2012,16 Suppl 2: 58-72.
[14]	Ali A, Musbahi O, White VLC , et al. Spinal tuberculosis: a literature review. JBJS Rev, 2019,7(1):e9.
[15]	吴伟光, 郭海龙 . 脊柱结核的早期诊断研究进展. 中国防痨杂志, 2018,40(5):531-534.
[16]	Adams S, Ehrlich R, Baatjies R , et al. Predictors of discordant latent tuberculosis infection test results amongst South African health care workers. BMC Infect Dis, 2019,19(1):131.
[17]	Jiang B, Ding H, Zhou L , et al. Evaluation of interferon-gamma release assay (T-SPOT.TB ^TM) for diagnosis of tuberculosis infection in rheumatic disease patients . Int J Rheum Dis, 2016,19(1):38-42.
[18]	Moon HW, Hur M . Interferon-gamma release assays for the diagnosis of latent tuberculosis infection: an updated review. Ann Clin Lab Sci, 2013,43(2):221-229.
[19]	王雅, 吴妹英, 杨坤云 , 等. 结核感染T细胞斑点试验在糖尿病并发肺结核诊断中的价值. 中国防痨杂志, 2018,40(8):846-853.
[20]	Yan L, Xiao H, Han M , et al. Diagnostic value of T-SPOT.TB interferon-gamma release assays for active tuberculosis. Exp Ther Med, 2015,10(1):345-351.
[21]	Aggarwal AN, Agarwal R, Gupta D , et al. Interferon Gamma Release Assays for Diagnosis of Pleural Tuberculosis: a Systematic Review and Meta-Analysis. J Clin Microbiol, 2015,53(8):2451-2459.
[22]	马秀英, 姚云清, 佘轩 , 等. T细胞酶联免疫斑点法诊断结核性脑膜炎的Meta分析. 重庆医学, 2014,43(25):3299-3301.
[23]	Auguste P, Tsertsvadze A, Pink J , et al. Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: systematic review and meta-analysis. BMC Infect Dis, 2017,17(1):200.
[24]	徐蕙, 李玥, 钱家鸣 . γ干扰素释放分析在亚洲地区肠结核与克罗恩病鉴别诊断中准确性评价的Meta分析. 中华内科杂志, 2016,55(7):535-540.

作者	发表年限	结核/非结核患者(例)	诊断标准	TP (例)	FP (例)	FN (例)	TN (例)	QUADAS评分 (分)
Yuan等^[5]	2013	29/32	病原/病理	24	6	5	26	12
李宝田等^[6]	2015	68/42	临床/病原/病理	62	4	6	38	10
汪锴等^[7]	2018	62/36	临床/病原/病理	58	3	4	33	10
杨雪梅等^[8]	2018	50/37	临床/病原/病理	41	3	9	34	11
刘汉辉等^[9]	2017	50/50	病原/病理	44	3	6	47	13
地里下提等^[10]	2014	112/44	临床/病原/病理	96	6	16	38	10
华裕忠等^[11]	2016	122/86	病原/病理	105	10	17	76	12
程红燕等^[12]	2017	98/77	临床/病原/病理	92	6	6	71	11