Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jan 9;9(1):e85030.
doi: 10.1371/journal.pone.0085030. eCollection 2014.

Utility of T-cell interferon-γ release assays for diagnosing tuberculous serositis: a prospective study in Beijing, China

Lifan Zhang  1 , Yueqiu Zhang  2 , Xiaochun Shi  2 , Yao Zhang  3 , Guohua Deng  2 , Ajit Lalvani  4 , Xiaoqing Liu  1
Affiliations

Utility of T-cell interferon-γ release assays for diagnosing tuberculous serositis: a prospective study in Beijing, China

Lifan Zhang et al. PLoS One. .

Abstract

Background: Diagnosis of tuberculous serositis remains a challenge. The aim of this study was to evaluate the diagnostic efficiency of T-SPOT.TB on serous effusion mononuclear cells (SEMC) for diagnosing tuberculous serositis in a high TB burden area.

Methods: The present prospective study enrolled patients with suspected tuberculous serositis in a tertiary referral hospital in Beijing, China, to investigate the diagnostic sensitivity, specificity, predictive value (PV), and likelihood ratio(LR) of these tests. Clinical assessment, T-SPOT.TB on SEMC, and T-SPOT.TB on PBMC were performed. Test results were compared with the final confirmed diagnosis.

Results: Of the 187 participants, 74 (39.6%) were microbiologically or clinically diagnosed as tuberculous serositis and 93(49.7%) were ruled out. The remaining 20 (10.7%) patients were clinically indeterminate and excluded from the final analysis. Compared to that on PBMC, T-SPOT.TB on SEMC showed higher sensitivity (91.9%vs73.0%, P = 0.002), specificity (87.1%vs.73.1%, P = 0.017), PPV (85.0%vs.68.4%, P = 0.013), NPV (93.1%vs.77.3%, P = 0.003), LR+ (7.12vs.2.72) and LR- (0.09vs.0.37), respectively. The frequencies of spot forming cells (SFCs) for T-SPOT.TB on SEMC were 636 per million SEMC (IQR, 143-3443) in patients with tuberculous serositis, which were 4.6-fold (IQR, 1.3-14.3) higher than those of PBMC. By ROC curve analysis, a cut-off value of 56 SFCs per million SEMC for T-SPOT.TB on SEMC showed a sensitivity of 90.5% and specificity of 89.2% for the diagnosis of tuberculous serositis.

Conclusions: T-SPOT.TB on SEMC could be an accurate diagnostic method for tuberculous serositis in TB endemic settings. And 56 SFCs per million SEMC might be the optimal cut-off value to diagnose tuberculous serositis.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: Professor Lalvani is inventor for patents underpinning T cell-based diagnosis. The ESAT-6/CFP-10 IFN-gamma ELISpot assay was commercialised by an Oxford University spin-out company (T-SPOT.TB®, Oxford Immunotec Ltd, Abingdon, UK) in which the University of Oxford and Professor Lalvani have minority shares of equity and royalty entitlements.

Figures

Figure 1
Figure 1. Frequencies of MTB-specific IFN-γ secreting T cells in serous effusion and peripheral blood.
The frequencies of ESAT-6 and CFP-10 specific IFN-γ secreting T cells in SEMC were significantly higher than those in PBMC (P = 0.002 for ESAT-6, P = 0.012 for CFP-10). The counts of IFN-γ secreting T cells specific for CFP-10 appeared higher than ESAT-6, but the difference were not statistically significant (P = 0.573 for serous effusion, P = 0.092 for peripheral blood). PBMC: peripheral blood mononuclear cell; SEMC: serous effusion mononuclear cells
Figure 2
Figure 2. ROC curves for T-SPOT.TB on SEMC and PBMC in patients with suspected tuberculous serositis.
The AUC of ROC curve was 0.938 (95%CI: 0.900–0.975,P<0.001) for T-SPOT.TB on SEMC, which was higher than that of T-SPOT.TB on PBMC (0.811,95%CI: 0.742–0.880,P<0.001). PBMC: peripheral blood mononuclear cell; SEMC: serous effusion mononuclear cells; ROC: receiver operating characteristic; AUC: area under the receiver operating characteristic curve.
See this image and copyright information in PMC

References

    1. Survey TGGotFNTE, Survey TOotFNTE (2012) The fifth national tuberculosis epidemiological survey in 2010. Chinese Journal of Antituberculosis 34.
    1. Jian-sheng H, Mei S, Ya-ling S (2000) Epidemiological Analysis of Extra-pulmonary Tuberculosis in Shanghai. CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES 23 - PubMed
    1. Xi-rong W, Bao-ping X, An-xia J, Ying-Hui H, Qing-qin Y, et al... (2012) The clinical epidemiological characteristics of pediatric tuberculosis in Beijing Children's Hospital from 2002 to 2010. CHINESE JOURNAL OF EVIDENCE BASED PEDIATRICS 07.
    1. Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR (2009) Epidemiology of extrapulmonary tuberculosis in the United States, 1993–2006. Clin Infect Dis 49: 1350–1357. - PubMed
    1. Sharma SK, Mohan A (2004) Extrapulmonary tuberculosis. Indian J Med Res 120: 316–353. - PubMed

Publication types

MeSH terms