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KMID : 0981820100300020171
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Korean Journal of Laboratory Medicine
2010 Volume.30 No. 2 p.171 ~ p.177
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Clinical Usefulness of T-SPOT.TB Test for the Diagnosis of Tuberculosis
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Kim Hyun-Soo
Kim Cheol-Hong
Hur Mi-Na
Hyun In-Gyu
Park Min-Jeong
Song Won-Keun
Park Ji-Young
Kang Hee-Jung
Lee Kyu-Man
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Abstract
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Background: Tuberculosis-specific ELISPOT assay (T-SPOT.TB, Oxford Immunotec, UK) is a test that detects interferon-gamma producing T-cells after stimulating patient’s lymphocytes with two kinds of tuberculosis-specific antigens (ESAT-6 and CFP-10). We evaluated clinical usefulness of T-SPOT.TB test in Korean adults with intermediate burden of tuberculosis and high rate of BCG vaccination at birth.
Methods: T-SPOT.TB test was performed in 79 patients and 64 healthy volunteers and these patients and volunteers were classified into four groups: group 1, patients with active tuberculosis (n=30); group 2, patients with not-active tuberculosis (n=27); group 3, patients without tuberculosis (n=24); group 4, healthy volunteers without tuberculosis history (n=62). Positive rates and average spot counts of T-SPOT.TB test were obtained among these groups.
Results: Positive rates of group 1 (96.4%) and group 2 (92.3%) were higher than those of group 3 (31.6%) and group 4 (27.4%) (P<0.0001). The sensitivity deduced from group 1 and specificity deduced from group 4 of T-SPOT.TB test were 96.4% and 72.6%, respectively. The average spot counts of group 1 and 2 were higher than those of group 3 and 4 (P<0.001). There was a tendency of increasing positive rate with increasing age. Overall agreement between T-SPOT.TB test and tuberculin skin test was 63.8% (kappa=0.29).
Conclusion: T-SPOT.TB test would be a very useful screening and supplementary test for diagnosis of tuberculosis due to its high sensitivity. However, positive results of T-SPOT.TB should be cautiously interpreted because of high positivity in treated tuberculosis patients and healthy volunteers in Korea. (Korean J Lab Med 2010;30:171-7)
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KEYWORD
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Tuberculosis, Interferon-gamma, ELISPOT
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