Value of interferon-γ release assays in the diagnosis of tuberculosis

doi:10.19983/j.issn.2096-8493.20230044

Abstract

Abstract:

Objective: To explore the application value of interferon-γ release assays (IGRA) in the diagnosis of tuberculosis. Methods: A retrospective study was conducted in 331 suspected tuberculosis patients with tuberculosis related symptoms and (or) signs from the tuberculosis clinic of the Fifth People’s Hospital of Suzhou from July to October 2022. All the subjects underwent IGRA testing and sputum smear testing. The diagnostic efficacy of IGRA and sputum smear for tuberculosis was evaluated by referring to the results of clinical comprehensive diagnosis. Results: Of the 331 subjects, 199 (60.12%) were diagnosed as tuberculosis, of which, the positive rate of IGRA was 83.92% (167/199), significantly higher than that of sputum smear (21.61% (43/199), χ²=155.000, P<0.01); the positive rate of IGRA detection in patients with prior pulmonary tuberculosis was 66.67% (10/15), which was significantly higher than that of sputum smear (6.67% (1/15), χ²=11.630, P<0.01); the positive detection rate of IGRA in active pulmonary tuberculosis patients was 83.83% (140/167), which was significantly higher than that of sputum smear (24.55% (41/167), χ²=118.200, P<0.01). The positive detection rate of IGRA in patients with other respiratory diseases was 31.82% (42/132), which was significantly lower than that in patients with tuberculosis (χ²=92.570, P<0.01). Taking the clinical comprehensive diagnosis results as reference, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of IGRA in detecting tuberculosis were 83.92% (167/199), 68.18% (90/132), 79.90% (167/209), 73.77% (90/122) and 77.64% (257/339) respectively; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of IGRA and sputum smear in parallel detection of tuberculosis were 87.44% (174/199), 60.61% (80/132), 76.99% (174/226), 76.19% (80/105) and 76.74% (254/339), respectively. Conclusion: IGRA has good auxiliary diagnostic value for tuberculosis.

Key words: Interferons, Tuberculosis, Diagnosis, differential, Retrospective studies

CLC Number:

R52
R825.2

Song Yiyan, Ma Liling, Chen Hui, Hang Yin, Chen Sufang, Xu Junchi, Wu Minjuan, Xu Ping. Value of interferon-γ release assays in the diagnosis of tuberculosis[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(4): 313-317. doi: 10.19983/j.issn.2096-8493.20230044

Figures/Tables 3

References 10

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患者类型	例数	阳性例数	阳性检出率(%)
结核病	199	167	83.92
陈旧性肺结核	15	10	66.67
活动性肺结核	167	140	83.83
肺外结核	8	8	8/8
脊柱结核	2	2	2/2
胸椎结核	1	1	1/1
泌尿系统结核	1	1	1/1
颈部淋巴结结核	1	1	1/1
右腋下淋巴结结核	1	1	1/1
腹腔结核	1	1	1/1
结核性脑脊髓炎	1	1	1/1
肺结核合并肺外结核	9	9	9/9
合并骨结核	1	1	1/1
合并支气管和纵隔淋巴结结核	3	3	3/3
合并泌尿系统结核	1	1	1/1
合并纵隔淋巴结结核	1	1	1/1
合并脊柱结核	1	1	1/1
合并喉结核	1	1	1/1
合并阴茎结核	1	1	1/1
其他呼吸道疾病	132	42	31.82
非结核分枝杆菌病	39	8	20.51
肺部感染	57	25	43.86
肺部阴影	5	1	1/5
肺脓肿	1	0	0.00
肺炎	11	4	36.36
急性上呼吸道感染	5	1	1/5
支气管扩张伴感染	2	0	0.00
支气管炎	11	2	18.18
支气管炎合并肺炎	1	1	1/1

患者类型	例数	阳性例数	阳性检出率(%)
结核病	199	43	21.61
陈旧性肺结核	15	1	6.67
活动性肺结核	167	41	24.55
肺外结核	8	0	0.00
肺结核合并肺外结核	9	1	1/9
合并骨结核	1	0	0.00
合并支气管和纵隔淋巴结结核	3	0	0.00
合并泌尿系统结核	1	1	1/1
合并纵隔淋巴结结核	1	0	0.00
合并脊柱结核	1	0	0.00
合并喉结核	1	0	0.00
合并阴茎结核	1	0	0.00
其他呼吸道疾病	132	14	10.61
非结核分枝杆菌病	39	12	30.77
肺部感染	57	2	3.51
肺部阴影	5	0	0.00
肺脓肿	1	0	0.00
肺炎	11	0	0.00
急性上呼吸道感染	5	0	0.00
支气管扩张伴感染	2	0	0.00
支气管炎	11	0	0.00
支气管炎合并肺炎	1	0	0.00

检测方法	临床综合诊断(例)		敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	准确度 (%)
检测方法	结核病^a	其他呼吸道疾病	敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	准确度 (%)
γ-干扰素释放试验			83.92	68.18	79.90	73.77	77.64
阳性	167	42
阴性	32	90
痰涂片			21.61	89.39	75.44	43.07	48.64
阳性	43	14
阴性	156	118
联合检测			87.44	60.61	76.99	76.19	76.74
阳性(至少1种方法阳性)	174	52
阴性(2种方法均阴性)	25	80

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