title: [Evaluation of T-SPOT.TB assay in the diagnosis of pulmonary tuberculosis within different age groups].
abstract: OBJECTIVE
  To evaluate the value of T-SPOT.TB assay in the diagnosis of pulmonary tuberculosis within different age groups.
  
  
  METHODS
  We analyzed 1 518 suspected pulmonary tuberculosis (PTB) patients who were admitted to the Beijing Chest Hospital from November 2012 to February 2014 and had valid T-SPOT.TB tests before anti-tuberculosis therapy. The 599 microbiologically and/or histopathologically-confirmed PTB patients (16-89 years old, 388 males and 211 females) and 235 non-TB patients (14-85 years old, 144 males and 91 females) were enrolled for the analysis of diagnostic performance of T-SPOT.TB, while patients with uncertain diagnosis or diagnosis based on clinical impression (n=684) were excluded from the analysis. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB were analyzed according to the final diagnosis. Furthermore, the diagnostic performance of T-SPOT.TB assay in the younger patients (14-59 years old) and elderly patients (60-89 years old) were also analyzed respectively. Categorical variables were compared by Pearson's Chi-square test, while continuous variables were compared by the Mann-Whitney U-test.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB in diagnosis of PTB were 90.1% (540/599), 65.5% (154/235), 86.9% (540/621), 72.3% (154/213), 2.61, and 0.15, respectively. The sensitivity and specificity of T-SPOT.TB assay were 92.6% (375/405) and 75.6% (99/131), respectively in the younger patients, and 85.0% (165/194), 52.9% (55/104) respectively in the elderly patients. The sensitivity and specificity of T-SPOT.TB assay in the younger patients were significantly higher than those in the elderly patients (P<0.01), and the spot forming cells in the younger PTB patients were significantly higher than in the elderly PTB patients [300 (126, 666)/10(6) PBMCs vs. 258 (79, 621)/10(6) PBMCs, P=0.037].
  
  
  CONCLUSIONS
  T-SPOT.TB is a promising test in the diagnosis of younger patients (14-59 years old) with suspected PTB, but the diagnostic performance in elderly patients (60-89 years old) is relatively reduced.
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Liping
authors: L
authors: Pan
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Hongyan
authors: H
authors: Jia
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Fei
authors: F
authors: Liu
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Mengqiu
authors: M
authors: Gao
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Huishan
authors: H
authors: Sun
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Boping
authors: B
authors: Du
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Qi
authors: Q
authors: Sun
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Aiying
authors: A
authors: Xing
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Rongrong
authors: R
authors: Wei
authors: Beijing Chest Hospital, Capital Medical University; Beijing Key Laboratory for Drug Resistant Tuberculosis Research; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China; Email: zzd417@163.com.
authors: Zongde
authors: Z
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D014397:Tuberculosis, Pulmonary; D055815:Young Adult