Interferon-gamma release assay performance of pleural fluid and peripheral blood in pleural tuberculosis

Fei Liu; Mengqiu Gao; Xia Zhang; Fengjiao Du; Hongyan Jia; Xinting Yang; Zitong Wang; Liqun Zhang; Liping Ma; Xiaoguang Wu; Li Xie; Zongde Zhang

doi:10.1371/journal.pone.0083857

Interferon-gamma release assay performance of pleural fluid and peripheral blood in pleural tuberculosis

PLoS One. 2013 Dec 27;8(12):e83857. doi: 10.1371/journal.pone.0083857. eCollection 2013.

Authors

Fei Liu¹, Mengqiu Gao², Xia Zhang¹, Fengjiao Du¹, Hongyan Jia¹, Xinting Yang², Zitong Wang³, Liqun Zhang², Liping Ma², Xiaoguang Wu², Li Xie², Zongde Zhang¹

Affiliations

¹ Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
² Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
³ Thoracic Surgery Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.

Abstract

Background: The diagnosis of pleural tuberculosis (TB) remains to be difficult. Interferon-gamma release assay (IGRA) is a promising method for diagnosing TB in low TB burden countries. The release of interferon-gamma (IFN-γ) by T lymphocytes increases at a localized site of infection with Mycobacterium tuberculosis antigen. This study aimed to examine the clinical accuracy of T-SPOT.TB on pleural fluid and peripheral blood for the diagnosis of pleural TB in high TB burden country.

Methods: 168 subjects with pleural effusion were enrolled prospectively and examined with T-SPOT.TB on pleural fluid and peripheral blood samples simultaneously.

Results: The receiver operating characteristic (ROC) curve and cut-off value of pleural fluid T-SPOT.TB was established according to spot forming cells (SFC) between culture/biopsy-confirmed pleural TB group and no pleural TB group. The sensitivity of pleural fluid T-SPOT.TB and peripheral blood T-SPOT.TB was similar (96.3% and 92.7%, respectively) (P= 0.691). In contrast, the specificity of pleural fluid T-SPOT.TB (94.5%) was significantly higher than that of peripheral blood T-SPOT.TB (76.1%) (P=0.002). 2% (2/98) of pleural fluid T-SPOT.TB results were indeterminate.

Conclusion: The diagnostic accuracy of peripheral blood T-SPOT.TB is low in high TB burden countries due to latent tuberculosis infection. Pleural fluid T-SPOT.TB is a relatively useful and supplementary test to explore pleural TB in high TB burden countries, but its diagnostic accuracy needs to be validated in further large scale research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adenosine Deaminase / metabolism
Adult
Aged
Body Fluids / metabolism*
Female
Humans
Interferon-gamma Release Tests / methods*
Male
Middle Aged
Pleura / metabolism*
ROC Curve
Tuberculosis, Pleural / blood*
Tuberculosis, Pleural / diagnosis*
Tuberculosis, Pleural / metabolism

Substances

Adenosine Deaminase

Grants and funding

This work was supported by grants of the National Major Project (2012ZX10003002-003), Beijing health systems of high-level health and technical personnel training plan (2009-3-51). It was also supported by Capital Science &Development fund (2009-3146). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.