Diagnostic performance of T-SPOT test for pediatric tuberculosis / 中国基层医药

ABSTRACT

Objective:To investigate the diagnostic performance of T-SPOT test for pediatric tuberculosis (TB).Methods:The results of T-SPOT and PPD in 67 TB children and 71 TB-excluded children that diagnosed and treated in the People's Hospital of Jianyang from June 2014 to May 2017 were retrospectively analyzed.The diagnostic efficacy and consistency of the two tests, and the diagnostic efficacy of combined examination were evaluated.Results:The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden′s index of T-SPOT were 88.1%, 94.4%, 93.7%, 89.3%, 15.6, 0.13, 0.83, respectively.While the above parameters of PPD were 68.7%, 74.6%, 71.9%, 71.6%, 2.71, 0.42, 0.43, respectively.T-SPOT had higher sensitivity, specificity, positive predictive value, negative predictive value compared with PPD, and the differences were statistically significant(χ 2=7.44, 10.54, 10.51, 7.45, all P<0.01). The positive rates of T-SPOT for pulmonary and extra-pulmonary TB were 90.9% and 82.6%, and the difference was not statistically significant ( P>0.05). The positive rate of T-SPOT was higher in 5-18 years old group than that in 0-4 years old group(95.1% vs.76.2 %, χ 2=5.01, P<0.05). The latter group held a diagnostic concordance greater than the former(kappa value 0.78 vs.0.23). The sensitivity of combined tests had no statistically significant difference compared with T-SPOT alone( P>0.05). Conclusion:T-SPOT outperformed PPD in diagnostic assistance of pediatric TB overall.The diagnostic superiority is noticeable in the>4-18 years old other than the 0-4 years old.Compared with T-SPOT alone, combined tests should not be regarded to have increased sensitivity.