PMID- 24416336
OWN - NLM
STAT- MEDLINE
DCOM- 20140902
LR  - 20240313
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 1
DP  - 2014
TI  - Utility of T-cell interferon-gamma release assays for diagnosing tuberculous 
      serositis: a prospective study in Beijing, China.
PG  - e85030
LID - 10.1371/journal.pone.0085030 [doi]
LID - e85030
AB  - BACKGROUND: Diagnosis of tuberculous serositis remains a challenge. The aim of 
      this study was to evaluate the diagnostic efficiency of T-SPOT.TB on serous 
      effusion mononuclear cells (SEMC) for diagnosing tuberculous serositis in a high 
      TB burden area. METHODS: The present prospective study enrolled patients with 
      suspected tuberculous serositis in a tertiary referral hospital in Beijing, 
      China, to investigate the diagnostic sensitivity, specificity, predictive value 
      (PV), and likelihood ratio(LR) of these tests. Clinical assessment, T-SPOT.TB on 
      SEMC, and T-SPOT.TB on PBMC were performed. Test results were compared with the 
      final confirmed diagnosis. RESULTS: Of the 187 participants, 74 (39.6%) were 
      microbiologically or clinically diagnosed as tuberculous serositis and 93(49.7%) 
      were ruled out. The remaining 20 (10.7%) patients were clinically indeterminate 
      and excluded from the final analysis. Compared to that on PBMC, T-SPOT.TB on SEMC 
      showed higher sensitivity (91.9%vs73.0%, P = 0.002), specificity (87.1%vs.73.1%, 
      P = 0.017), PPV (85.0%vs.68.4%, P = 0.013), NPV (93.1%vs.77.3%, P = 0.003), LR+ 
      (7.12vs.2.72) and LR- (0.09vs.0.37), respectively. The frequencies of spot 
      forming cells (SFCs) for T-SPOT.TB on SEMC were 636 per million SEMC (IQR, 
      143-3443) in patients with tuberculous serositis, which were 4.6-fold (IQR, 
      1.3-14.3) higher than those of PBMC. By ROC curve analysis, a cut-off value of 56 
      SFCs per million SEMC for T-SPOT.TB on SEMC showed a sensitivity of 90.5% and 
      specificity of 89.2% for the diagnosis of tuberculous serositis. CONCLUSIONS: 
      T-SPOT.TB on SEMC could be an accurate diagnostic method for tuberculous 
      serositis in TB endemic settings. And 56 SFCs per million SEMC might be the 
      optimal cut-off value to diagnose tuberculous serositis.
FAU - Zhang, Lifan
AU  - Zhang L
AD  - Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Sciences & Peking Union Medical College, Beijing, China ; 
      Clinical Epidemiology Unit, Peking Union Medical College, International Clinical 
      Epidemiology Network, Beijing, China.
FAU - Zhang, Yueqiu
AU  - Zhang Y
AD  - Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
FAU - Shi, Xiaochun
AU  - Shi X
AD  - Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
FAU - Zhang, Yao
AU  - Zhang Y
AD  - Clinical Epidemiology Unit, Peking Union Medical College, International Clinical 
      Epidemiology Network, Beijing, China.
FAU - Deng, Guohua
AU  - Deng G
AD  - Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
FAU - Lalvani, Ajit
AU  - Lalvani A
AD  - Department of Respiratory Medicine, National Heart and Lung Institute, Imperial 
      College London, London, United Kingdom.
FAU - Liu, Xiaoqing
AU  - Liu X
AD  - Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Sciences & Peking Union Medical College, Beijing, China ; 
      Clinical Epidemiology Unit, Peking Union Medical College, International Clinical 
      Epidemiology Network, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140109
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Reagent Kits, Diagnostic)
RN  - 82115-62-6 (Interferon-gamma)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ascites/*diagnosis/immunology/pathology
MH  - Cell Count
MH  - China
MH  - Female
MH  - Humans
MH  - Interferon-gamma/*analysis/metabolism
MH  - Male
MH  - Middle Aged
MH  - Pericardial Effusion/*diagnosis/immunology/pathology
MH  - Pleural Effusion/*diagnosis/immunology/pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - ROC Curve
MH  - Reagent Kits, Diagnostic
MH  - Serositis/complications/*diagnosis/immunology/pathology
MH  - T-Lymphocytes/immunology/pathology
MH  - Tertiary Care Centers
MH  - Tuberculosis/complications/*diagnosis/immunology/pathology
PMC - PMC3887014
COIS- Competing Interests: Professor Lalvani is inventor for patents underpinning T 
      cell-based diagnosis. The ESAT-6/CFP-10 IFN-gamma ELISpot assay was 
      commercialised by an Oxford University spin-out company (T-SPOT.TBA(R), Oxford 
      Immunotec Ltd, Abingdon, UK) in which the University of Oxford and Professor 
      Lalvani have minority shares of equity and royalty entitlements.
EDAT- 2014/01/15 06:00
MHDA- 2014/09/03 06:00
PMCR- 2014/01/09
CRDT- 2014/01/14 06:00
PHST- 2013/08/25 00:00 [received]
PHST- 2013/11/21 00:00 [accepted]
PHST- 2014/01/14 06:00 [entrez]
PHST- 2014/01/15 06:00 [pubmed]
PHST- 2014/09/03 06:00 [medline]
PHST- 2014/01/09 00:00 [pmc-release]
AID - PONE-D-13-35037 [pii]
AID - 10.1371/journal.pone.0085030 [doi]
PST - epublish
SO  - PLoS One. 2014 Jan 9;9(1):e85030. doi: 10.1371/journal.pone.0085030. eCollection 
      2014.