Interferon-Gamma Release Assay Performance of Cerebrospinal Fluid and Peripheral Blood in Tuberculous Meningitis in China.
The aim of this study was to examine the performance of T-SPOT.TB on cerebrospinal fluid (CSF) and peripheral blood (PB) in diagnosis of tuberculous meningitis (TBM) in China. Of 100 patients with presumed TBM prospectively enrolled from Sep 2012 to Oct 2014, 53 were TBM (21 definite and 32 probable TBM cases) and 37 were non-TBM cases; the other 10 patients were excluded from analysis due to inconclusive diagnosis, no sufficient CSF samples, or incomplete follow-up. T-SPOT.TB on CSF and PB and routine laboratory tests of CSF were performed simultaneously. The receiver operating characteristic (ROC) curve and cut-off value of CSF T-SPOT.TB and routine CSF parameters were established between TBM and non-TBM group. The area under ROC curve (AUC) of the T-SPOT.TB on CSF and PB was 0.81 and 0.89, which was higher than that of the routine CSF parameters (AUC 0.67-0.77). Although the sensitivity of CSF T-SPOT.TB was lower than that of PB T-SPOT.TB (60.8% versus 90.6%,P< 0.001), the specificity of CSF T-SPOT.TB was significantly higher than that of PB T-SPOT.TB (97.2% versus 75.7%,P= 0.007). These results indicated that the diagnostic accuracies of PB and CSF T-SPOT.TB are higher than routine laboratory tests. Furthermore, the higher specificity of CSF T-SPOT.TB makes it a useful rule-in test in rapid diagnosis of TBM.
Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Liping
0000-0001-6172-3630
L
Pan
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Fei
F
Liu
Neurology Department, People's Liberation Army 263 Hospital, 141 Yongshun South Street, Tongzhou District, Beijing 101149, China.
Jinli
J
Zhang
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Xinting
X
Yang
Neurosurgery Department, Beijing Luhe Hospital, 82 Xinhua South Street, Tongzhou District, Beijing 101110, China.
Shiqi
S
Zheng
Neurology Department, People's Liberation Army 263 Hospital, 141 Yongshun South Street, Tongzhou District, Beijing 101149, China.
Jing
J
Li
Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Hongyan
H
Jia
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Xiaoyou
X
Chen
Tuberculosis Department, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Mengqiu
M
Gao
Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, 97 Machang Road, Tongzhou District, Beijing 101149, China.
Zongde
0000-0003-0857-9793
Z
Zhang
D000328:Adult; D019540:Area Under Curve; D002681:China; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D055815:Young Adult
D007371:Interferon-gamma