Abstract | BACKGROUND: METHODS: Participants were consecutively recruited based on positive T-SPOT.TB results between January 2018 and January 2020. ATB was diagnosed by positive mycobacterial culture and/or positive GeneXpert MTB/RIF, with clinical symptoms and radiological characteristics suggestive of ATB. Individuals with positive T-SPOT.TB but without the evidence of ATB were defined as LTBI. Patients younger than 17 years and undergoing anti-TB treatment were excluded. RESULTS: A total of 709 (312 ATB and 397 LTBI) and another 309 (120 ATB and 189 LTBI) subjects were respectively recruited from Tongji Hospital (Qiaokou cohort) and Sino-French New City Hospital (Caidian cohort). The level of prealbumin was significantly lower in ATB than in LTBI. With a cut-off value of 139 mg/L, the sensitivity and specificity of prealbumin in distinguishing ATB from LTBI were 50.96% (45.41%-56.51%) and 91.69% (88.97%-94.40%). Meanwhile, TBAg/PHA ratio was found statistically higher in ATB compared with LTBI. If using the threshold of 0.29, the sensitivity and specificity of TBAg/PHA ratio were 65.71% (60.44%-70.97%) and 90.93% (88.11%-93.76%), respectively. Moreover, the combination of prealbumin and TBAg/PHA ratio (obtaining by diagnostic model) yielded better specificity (90.18%, [87.25%-93.10%]) and sensitivity (87.18%, [83.47%-90.89%]), while the clinical utility index (CUI) positive and CUI negative were respectively 0.76 and 0.81. After anti-TB treatment, TBAg/PHA ratio was declined while the level of prealbumin was restored (Wilcoxon test, P < 0.001). Furthermore, the performance of diagnostic model obtained in Qiaokou cohort was confirmed in Caidian cohort. CONCLUSIONS: The diagnostic model based on combination of prealbumin and TBAg/PHA ratio is a rapid and accurate tool for discriminating ATB from LTBI.
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Authors | Ying Luo, Ying Xue, Xu Yuan, Qun Lin, Guoxing Tang, Liyan Mao, Huijuan Song, Feng Wang, Ziyong Sun |
Journal | International journal of clinical practice
(Int J Clin Pract)
Vol. 75
Issue 4
Pg. e13831
(Apr 2021)
ISSN: 1742-1241 [Electronic] India |
PMID | 33175465
(Publication Type: Journal Article)
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Copyright | © 2020 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd. |
Chemical References |
- Antigens, Bacterial
- Phytohemagglutinins
- Prealbumin
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Topics |
- Antigens, Bacterial
- Humans
- Latent Tuberculosis
(diagnosis)
- Mycobacterium tuberculosis
- Phytohemagglutinins
- Prealbumin
- Tuberculosis
(diagnosis, drug therapy)
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