Comparison of the Tuberculin Skin Test and the Interferon-γ Release Assay for the Diagnosis of Cervical Tuberculous Lymphadenitis

Abstract

Received March 6, 2013 Revised April 15, 2013 Accepted April 22, 2013 Address for correspondence Jeong Kyu Kim, MD, PhD Department of OtolaryngologyHead and Neck Surgery, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea Tel +82-53-650-4071 Fax +82-53-650-4533 E-mail doctorjkkim@cu.ac.kr Background and ObjectivesZZTo compare the tuberculin skin test (TST) and the interferon γ release assay (IGRA) for the diagnosis of cervical tuberculous lymphadenitis (TL). Subjects and MethodZZA prospective comparison between the TST and the IGRA was performed in subjects who met the inclusion criteria for suspicious cervical TL. TL was confirmed by culture results and clinical diagnosis of TL was also made by histology, polymerase chain reaction and treatment response of the anti-tuberculosis drug. ResultsZZOf the 43 subjects enrolled, 11 subjects were confirmed as TL, nine subjects as clinical TL and 23 subjects as non-TL. The TST and the IGRA were all positive in TL. The agreement between the TST and IGRA was κ=0.40 in both clinical TL and non-TL. The sensitivity and specificity of the TST were 95.0% [95% confidence interval (CI), 92.1-97.9] and 39.1% (95% CI, 32.6-45.6), respectively. By comparison, the sensitivity and specificity of the IGRA were 85.0% (95% CI, 80.3-89.8) and 52.2% (95% CI, 45.5-58.8), respectively. ConclusionZZThe IGRA was more specific than the TST, while the TST was more sensitive than the IGRA. The higher specificity of IGRA could make IGRA play a useful adjunct role in the diagnosis for cervical TL. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:354-8