Abstract：Objective To evaluate the performance of interferon-γ release assay (IGRAs) in patients with suspected cervical tuberculous lymphadenitis. Methods From December 2014 to April 2016, 94 patients with abnormal cervical lymph node in People′s Hospital of Xinjiang Uygur Autonomous Region were categorized into cervical tuberculous lymphadenitis group (52 cases) and nonactive cervical tuberculous lymphadenitis group (42 cases) according to histopathologic and microbiological findings. IGRAs using peripheral blood mononuclear cells was performed to examine the IFN-γ response to the Mycobacterium tuberculosis-specific antigens. The number of cells (SFCs) in two groups was compared. Results SFCs median in cervical tuberculous lymphadenitis group (90) was significantly higher than that in non-cervical tuberculous lymphadenitis group (0), the difference was statistically significant (P ＜ 0.05). The sensitivity of peripheral blood gamma-interferon release assay was 92.31% (48/52), the specificity was 69.05% (29/42), the positive predictive value was 78.69%, the negative predictive value was 87.88%. Conclusion In a high tuberculosis burden setting, results of IGRAs are of limited value in the diagnosis of cervical tuberculous lymphadenitis.
[1] Mijiti P，Yuehua L，Feng X，et al. Prevalence of pulmonary tuberculosis in western China in 2010–11：a population-based，cross-sectional survey [J]. Lancet Global Health，2016， 4（7）：e485-e494.
[2] 王黎霞，成诗明，陈明亭，等.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志，2012（8）：485-508.
[3] Zumla A，George A，Sharma V，et al. The WHO 2014 globaltuberculosis report—further to go [J]. Lancet Glob Health，2015，3（1）：e10-e12.
[4] Fan L，Chen Z，Hao XH，et al. Interferon-gamma release assays for the diagnosis of extrapulmonary tuberculosis：a systematic review and meta-analysis [J]. FEMS Immunol Med Microbiol，2012，65（3）：456-466.
[5] Shin JA，Chang YS，Kim HJ，et al. Diagnostic utility of interferon-gamma release assay in extrapulmonary tuberculosis [J]. Diagn Microbiol Infect Dis，2015，82（1）：44-48.
[6] Kim KH，Kim RB，Woo SH. The efficacy of the interferon-gamma release assay for diagnosing cervical tuberculous lymphadenitis：a prospective controlled study [J]. Laryngoscope，2016，126（2）：378-384.
[7] Jia H，Pan L，Du B，et al. Diagnostic performance of interferon-γ release assay for lymph node tuberculosis [J]. Diagnost Microbiol Infect Dis，2016，85（1）：56-60.
[8] 中华医学会.临床诊疗指南：结核病分册[M].北京：人民卫生出版社，2005：27-28.
[9] Purohit MR，Mustafa T，Morkve O，et al. Gender differences in the clinical diagnosis of tuberculous lymphadenitis--a hospital-based study from Central India [J]. Int J Infect Dis，2009，13（5）：600-605.
[10] Mustafa T，Brokstad KA，Mfinanga SG，et al. Multiplex analysis of pro-or anti-inflammatory serum cytokines and chemokines in relation to gender and age among tanzanian tuberculous lymphadenitis patients [J]. Tuberc Res Treat， 2015，2015：561490.
[11] Getahun H，Matteelli A，Chaisson RE，et al. Latent mycobacterium tuberculosis infection [J]. New Engl J Med，2015，372（22）：2127-2135.
[12] 贾红彦，潘丽萍，刘菲，等.结核分枝杆菌感染T细胞斑点试验对淋巴结结核的辅助诊断价值研究[J].中国防痨杂志，2014，36（6）：467-471.
[13] Getahun H，Matteelli A，Abubakar I，et al. Management of latent mycobacterium tuberculosis infection：WHO guidelines for low tuberculosis burden countries [J]. Eur Respir J，2015：ERJ-01245-2015.
[14] Diel R，Goletti D，Ferrara G，et al. Interferon-gamma release assays for the diagnosis of latent Mycobacterium tuberculosis infection：a systematic review and meta-analysis [J]. Eur Respir J，2011，37（1）：88-99.
[15] Wu X，Hou Y，Liang Y，et al. Evaluation of a tuberculosis whole-blood interferon-γ chemiluminescent immunoassay among chinese military recruits [J]. Mol Diagn Ther，2011，15（6）：341-346.
[16] Gao L，Lu W，Bai L，et al. Latent tuberculosis infection in rural China：baseline results of a population-based，multicentre，prospective cohort study [J]. Lancet Infect Dis，15（3）：310-319.
[17] Zhou F，Zhang L，Gao L，et al. Latent tuberculosis infection and occupational protection among health care workers in two types of public hospitals in China [J]. PLoS One，2014，9（8）：e104673.
[18] Zhang X，Jia H，Liu F，et al. Prevalence and risk factors for latent tuberculosis infection among health care workers in China：a cross-sectional study [J]. PLoS One，2013，8（6）：e66412.
[19] Fan L，Chen Z，Hao XH，et al. Interferon-gamma release assays for the diagnosis of extrapulmonary tuberculosis：a systematic review and meta-analysis [J]. FEMS Immunol Med Microbiol，2012，65（3）：456-466.
[20] Rangaka MX，Wilkinson KA，Glynn JR，et al. Predictive value of interferon-gamma release assays for incident active tuberculosis：a systematic review and meta-analysis [J]. Lancet Infect Dis，2012，12（1）：45-55.
[21] Sester M，Sotgiu G，Lange C，et al. Interferon-gamma release assays for the diagnosis of active tuberculosis：a systematic review and meta-analysis [J]. Eur Respir J，2011， 37（1）：100-111.
[22] 杨成云，涂志永，丁超，等.结核杆菌特异性细胞免疫反应检测(酶联免疫法)临床应用探讨[J].中国当代医药，2016，23（30）：146-148.
[23] 中华医学会结核病学分会.γ-干扰素释放试验在中国应用的建议[J].中华结核和呼吸杂志，2014，37（10）：744-747.
2017, Vol. 14 
京公网安备 11010502046598号