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Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection
BACKGROUND: Distinguishing between active tuberculosis (ATB) and latent tuberculosis infection (LTBI) remains challenging. METHODS: Between 2013 and 2019, 2,059 (1,097 ATB and 962 LTBI) and another 883 (372 ATB and 511 LTBI) participants were recruited based on positive T-SPOT.TB (T-SPOT) results fr...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279757/ https://www.ncbi.nlm.nih.gov/pubmed/34277462 http://dx.doi.org/10.3389/fcimb.2021.575650 |
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author | Luo, Ying Tang, Guoxing Yuan, Xu Lin, Qun Mao, Liyan Song, Huijuan Xue, Ying Wu, Shiji Ouyang, Renren Hou, Hongyan Wang, Feng Sun, Ziyong |
author_facet | Luo, Ying Tang, Guoxing Yuan, Xu Lin, Qun Mao, Liyan Song, Huijuan Xue, Ying Wu, Shiji Ouyang, Renren Hou, Hongyan Wang, Feng Sun, Ziyong |
author_sort | Luo, Ying |
collection | PubMed |
description | BACKGROUND: Distinguishing between active tuberculosis (ATB) and latent tuberculosis infection (LTBI) remains challenging. METHODS: Between 2013 and 2019, 2,059 (1,097 ATB and 962 LTBI) and another 883 (372 ATB and 511 LTBI) participants were recruited based on positive T-SPOT.TB (T-SPOT) results from Qiaokou (training) and Caidian (validation) cohorts, respectively. Blood routine examination (BRE) was performed simultaneously. Diagnostic model was established according to multivariate logistic regression. RESULTS: Significant differences were observed in all indicators of BRE and T-SPOT assay between ATB and LTBI. Diagnostic model built on BRE showed area under the curve (AUC) of 0.846 and 0.850 for discriminating ATB from LTBI in the training and validation cohorts, respectively. Meanwhile, TB-specific antigens spot-forming cells (SFC) (the larger of early secreted antigenic target 6 and culture filtrate protein 10 SFC in T-SPOT assay) produced lower AUC of 0.775 and 0.800 in the training and validation cohorts, respectively. The diagnostic model based on combination of BRE and T-SPOT showed an AUC of 0.909 for differentiating ATB from LTBI, with 78.03% sensitivity and 90.23% specificity when a cutoff value of 0.587 was used in the training cohort. Application of the model to the validation cohort showed similar performance. The AUC, sensitivity, and specificity were 0.910, 78.23%, and 90.02%, respectively. Furthermore, we also assessed the performance of our model in differentiating ATB from LTBI with lung lesions. Receiver operating characteristic analysis showed that the AUC of established model was 0.885, while a threshold of 0.587 yield a sensitivity of 78.03% and a specificity of 85.69%, respectively. CONCLUSIONS: The diagnostic model based on combination of BRE and T-SPOT could provide a reliable differentiation between ATB and LTBI. |
format | Online Article Text |
id | pubmed-8279757 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82797572021-07-15 Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection Luo, Ying Tang, Guoxing Yuan, Xu Lin, Qun Mao, Liyan Song, Huijuan Xue, Ying Wu, Shiji Ouyang, Renren Hou, Hongyan Wang, Feng Sun, Ziyong Front Cell Infect Microbiol Cellular and Infection Microbiology BACKGROUND: Distinguishing between active tuberculosis (ATB) and latent tuberculosis infection (LTBI) remains challenging. METHODS: Between 2013 and 2019, 2,059 (1,097 ATB and 962 LTBI) and another 883 (372 ATB and 511 LTBI) participants were recruited based on positive T-SPOT.TB (T-SPOT) results from Qiaokou (training) and Caidian (validation) cohorts, respectively. Blood routine examination (BRE) was performed simultaneously. Diagnostic model was established according to multivariate logistic regression. RESULTS: Significant differences were observed in all indicators of BRE and T-SPOT assay between ATB and LTBI. Diagnostic model built on BRE showed area under the curve (AUC) of 0.846 and 0.850 for discriminating ATB from LTBI in the training and validation cohorts, respectively. Meanwhile, TB-specific antigens spot-forming cells (SFC) (the larger of early secreted antigenic target 6 and culture filtrate protein 10 SFC in T-SPOT assay) produced lower AUC of 0.775 and 0.800 in the training and validation cohorts, respectively. The diagnostic model based on combination of BRE and T-SPOT showed an AUC of 0.909 for differentiating ATB from LTBI, with 78.03% sensitivity and 90.23% specificity when a cutoff value of 0.587 was used in the training cohort. Application of the model to the validation cohort showed similar performance. The AUC, sensitivity, and specificity were 0.910, 78.23%, and 90.02%, respectively. Furthermore, we also assessed the performance of our model in differentiating ATB from LTBI with lung lesions. Receiver operating characteristic analysis showed that the AUC of established model was 0.885, while a threshold of 0.587 yield a sensitivity of 78.03% and a specificity of 85.69%, respectively. CONCLUSIONS: The diagnostic model based on combination of BRE and T-SPOT could provide a reliable differentiation between ATB and LTBI. Frontiers Media S.A. 2021-06-29 /pmc/articles/PMC8279757/ /pubmed/34277462 http://dx.doi.org/10.3389/fcimb.2021.575650 Text en Copyright © 2021 Luo, Tang, Yuan, Lin, Mao, Song, Xue, Wu, Ouyang, Hou, Wang and Sun https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cellular and Infection Microbiology Luo, Ying Tang, Guoxing Yuan, Xu Lin, Qun Mao, Liyan Song, Huijuan Xue, Ying Wu, Shiji Ouyang, Renren Hou, Hongyan Wang, Feng Sun, Ziyong Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title | Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title_full | Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title_fullStr | Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title_full_unstemmed | Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title_short | Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection |
title_sort | combination of blood routine examination and t-spot.tb assay for distinguishing between active tuberculosis and latent tuberculosis infection |
topic | Cellular and Infection Microbiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279757/ https://www.ncbi.nlm.nih.gov/pubmed/34277462 http://dx.doi.org/10.3389/fcimb.2021.575650 |
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