Comparison of the Tuberculin Skin Test and the Interferon-gamma Release Assay for the Diagnosis of Cervical Tuberculous Lymphadenitis / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: To compare the tuberculin skin test (TST) and the interferon gamma release assay (IGRA) for the diagnosis of cervical tuberculous lymphadenitis (TL). SUBJECTS AND METHOD: A prospective comparison between the TST and the IGRA was performed in subjects who met the inclusion criteria for suspicious cervical TL. TL was confirmed by culture results and clinical diagnosis of TL was also made by histology, polymerase chain reaction and treatment response of the anti-tuberculosis drug. RESULTS: Of the 43 subjects enrolled, 11 subjects were confirmed as TL, nine subjects as clinical TL and 23 subjects as non-TL. The TST and the IGRA were all positive in TL. The agreement between the TST and IGRA was kappa=0.40 in both clinical TL and non-TL. The sensitivity and specificity of the TST were 95.0% [95% confidence interval (CI), 92.1-97.9] and 39.1% (95% CI, 32.6-45.6), respectively. By comparison, the sensitivity and specificity of the IGRA were 85.0% (95% CI, 80.3-89.8) and 52.2% (95% CI, 45.5-58.8), respectively. CONCLUSION: The IGRA was more specific than the TST, while the TST was more sensitive than the IGRA. The higher specificity of IGRA could make IGRA play a useful adjunct role in the diagnosis for cervical TL.