Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2009, Vol. 31 ›› Issue (4): 443-448.doi: 10.3881/j.issn.1000-503X.2009.04.012

• Original Articles • Previous Articles     Next Articles

Role of Enzyme-linked Immunospot Assay and Tuberculin Skin Test in the Auxiliary Diagnosis of Initial Pulmonary Tuberculosis

LIU Fei1;ZHANG Zong-de2;CAO Min1; MA Li-ping1; GAO Meng-qiu1;WU Xiao-guang1;ZHU Li-zhen1; MA Yu1   

  1. 1Department of Tuberculosis,2Laboratory of Molecular Biology for Tuberculosis, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
  • Received:2009-03-05 Revised:1900-01-01 Online:2009-08-30 Published:2009-08-30
  • Contact: ZHANG Zong-de

Abstract: ABSTRACT:Objective To compare enzyme-linked immunospot assay (ELISPOT) and tuberculin skin test (TST) and explore their roles in the auxiliary diagnosis of initial pulmonary tuberculosis. Methods Totally 123 patients with initial pulmonary tuberculosis (tuberculosis group) and 102 patients with non-tuberculosis pulmonary disease (control group) were enrolled. The peripheral blood mononuclear cells of all participants were co-cultured with early secretiny antigen target-6/culture filtrate protein-10 fusion protein (ESAT-6/CFP-10 ), and spot forming cells (SFCs) were enumerated by ELISPOT (ESAT-6/CFP-10-ELISPOT). TST was also performed simultaneously. Results ESAT-6/CFP-10-ELISPOT showed significantly higher numbers of SFCs after stimulation in tuberculosis group than in control group (P=0.000). The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of ESAT-6/CFP-10-ELISPOT were 91.1% (111/123), 81.4% (82/102),4.60, 0.12, 0.85, and 0.87 respectively, while the above values of TST were 65.6%(59/90), 45.1% (46/102),1.31, 0.76, 0.51, and 0.60, respectively. The sensitivity and specificity of ESAT-6/CFP-10-ELISPOT were significantly higher than those of TST(all P=0.000). The number of SFCs were not significantly different between smear-positive tuberculosis subgroup and smear-negative tuberculosis subgroup (P=0.166). The sensitivities were 91.8%(67/73) and 88.0%(44/50) in these two subgroups, respectively, (P=0.448). Conclusions ESAT-6/CFP-10-ELISPOT may be a more accurate approach for the auxiliary diagnosis of initial pulmonary tuberculosis; meanwhile, it offers certain diagnostic evidences for smear-negative tuberculosis. However, its specificity may be affected by latent tuberculosis infection. On the contrary, TST has poor value in the auxiliary diagnosis of initial pulmonary tuberculosis.

Key words: enzyme-linked immunospot assay, tuberculin skin test, auxiliary diacnosis, initial pulmonary tuberculosis