title: Interferon-gamma release assay performance of pleural fluid and peripheral blood in pleural tuberculosis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Mengqiu
authors.initials: M
authors.lastname: Gao
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Fengjiao
authors.initials: F
authors.lastname: Du
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Jia
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Xinting
authors.initials: X
authors.lastname: Yang
authors.affiliation: Thoracic Surgery Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Zitong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Liqun
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Ma
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Wu
authors.affiliation: Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xie
authors.affiliation: Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Zongde
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000243:Adenosine Deaminase / Q000378:metabolism; D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000378:metabolism*; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000378:metabolism*; D012372:ROC Curve; D014396:Tuberculosis, Pleural / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D000243:Adenosine Deaminase