Abstract
BackgroundThe goal of this study was to further investigate the clinical effectiveness of the T-SPOT.TB test in diagnosing tuberculosis (TB), including the effects of T-SPOT.TB test on evaluating diverse TB types and locations.MethodsWe collected 20,332 specimens from patients suspected to have TB. Afterwards, we performed an integrative analysis of T-SPOT.TB results and clinical diagnoses, and evaluated the composition ratio and positive detection rate of the T-SPOT.TB test in various age groups, sample types, and hospital departments. In addition, we compared the spot number and composition rate between latent TB infection (LTBI), active TB infection, and old TB infection groups. The active TB group was then further divided into pulmonary TB (PTB), pulmonary and extrapulmonary TB (PETB), and extrapulmonary TB (EPTB) subgroups, and we evaluated whether there were statistical differences in spot number and composition rate between subgroups.ResultsPositive results from the T-SPOT.TB test were found across different age groups, specimen types, and hospital departments. Elderly patient groups, pleural effusion samples, and thoracic surgery departments showed the highest rates of positivity. There were no statistically significant differences in spot number of CFP-10 and ESAT-6 wells between disease groups or active TB subgroups. The composition rate, however, was significantly different when ESAT-6 and CFP-10 wells were double-positive. The spot number and composition rate were statistically different between the three disease groups, but showed no significant differences between the three subgroups of active TB.ConclusionsThe results of T-SPOT. TB test showed differences in LTBI, active TB and old TB. Additionally, a higher spot number level was observed in the active TB group.
Highlights
The goal of this study was to further investigate the clinical effectiveness of the T-SPOT.TB test in diagnosing tuberculosis (TB), including the effects of T-SPOT.TB test on evaluating diverse TB types and locations
Distribution of T-SPOT.TB results in different ages A total of 20,332 patients were distributed into various age groups, of which the childhood group had the fewest individuals (0–6 years old; 68 cases), while the overwhelming majority of patients belonged to the middleaged group (41–65 years old; 9735 cases)
The results revealed that the spot number for culture filtrate protein 10 (CFP-10) and Early secreted antigenic target 6 (ESAT-6) microwells in each subgroup were not significantly different (p > 0.05), but the composition rate in each subtype was significantly different when CFP-10 and ESAT-6 microwells were double positive (p < 0.01)
Summary
The goal of this study was to further investigate the clinical effectiveness of the T-SPOT.TB test in diagnosing tuberculosis (TB), including the effects of T-SPOT.TB test on evaluating diverse TB types and locations. Tuberculosis (TB) is a common chronic disease caused by infection with the facultative intracellular pathogenic bacteria Mycobacterium tuberculosis, and is a serious danger to public health [1]. It has been reported that Mycobacterium tuberculosis (M.TB) can spread hematogenously to various tissues and organs including the lung apices, lymph nodes, spleen, and liver, which has been considered to be one crucial infectious source in TB occurrence [2]. TB characteristics tend to be concealed by complications and other symptoms because of the growing numbers of elderly patients, increasing patients with drug resistance and extensive immune impairment, causing the slow progression of TB, atypical symptoms and misdiagnosis or missed-diagnosis in clinical examinations [6]. It is essential to control TB progression, and undertake early prevention, diagnosis, and treatment
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