结核γ-干扰素释放检测、核酸扩增检测联合结核感染T细胞监测对肿瘤合并结核感染患者的指导意义  

The Clinical Significance of TB-IGRA,GeneXpert Combined with T Cell Monitoring for Tumor Patients with Concurrent Tuberculosis Infection

作　　者：王琳[1] 张偲[1] 马小宏 程宜[1] 宋晗 董颖 丁小红[1] WANG Lin;ZHANG Yin;MA Xiaohong;CHENG Yi;SONG Han;DONG Ying;DING Xiaohong(Department of Laboratory Medicine,The People's Hospital of Rugao,Rugao,Jiangsu 226500,China)

机构地区：[1]江苏省如皋市人民医院检验科,江苏如皋226500

出　　处：《转化医学杂志》2024年第3期359-362,共4页Translational Medicine Journal

基　　金：南通市社会民生科技计划-指导性项目(MSZ2023137)。

摘　　要：目的 探讨结核γ-干扰素释放检测(TB-IGRA)、核酸扩增检测联合结核感染T细胞监测在肿瘤合并结核感染患者检测中的应用价值,分析其诊断能力。方法 收集2023年9月至2024年6月江苏省如皋市人民医院收治的100例肿瘤患者的资料进行回顾性分析,按照是否并合并结核感染分为感染组(23例)和未感染组(77例)。分析2组患者的临床资料,比较TB-IGRA、核酸扩增检测、结核感染T细胞监测3种检测技术阳性检出率差异,比较其检出能力。结果 临床细菌学检查证实肿瘤合并结核感染23例(23%),未感染77例(77%),感染组与未感染组的性别比例、年龄分布、肿瘤分类比较,差异无统计学意义(P> 0.05)。TB-IGRA检出结核菌阳性率65.22%(15/23),核酸扩增检测为47.83%(11/23),结核感染T细胞监测为55.52%(13/23)。联合应用3种检测技术时,结核菌阳性检出率为82.61%(19/23),明显高于单独检测(P <0.05)。结论 TB-IGRA检出的肿瘤合并结核感染患者的阳性率最高,3种检测技术联合应用阳性检出率明显高于单独应用,具有较好的临床应用价值。Objective To evaluate the combined application ofγ-interferon release detection technology(TB-IGRA),real-time fluorescence quantitative nucleic acid amplification detection technology(GeneXpert),and T cell monitoring strategy in cancer patients with concurrent tuberculosis infection,and investigate its diagnostic ability.Methods A retrospective analysis was conducted for 100 cancer patients who were admitted to The People's Hospital of Rugao from Sep.2023 to Jun.2024.They were divided into co-infection group(23 cases)and tumor-only group(77 cases)based on whether they were co-infected with tuberculosis.Clinical data for all patients were analyzed,and the positive rates of TB-IGRA,GeneXpert,and T cell monitoring for all tumor patients were calculated,and their detection capabilities were compared.Results Clinical bacteriological examination confirmed that there were 23 cases(23%)of tumor patients with combined tuberculosis infection and 77 cases(77%)of uninfected patients.There were no statistically significant differences between infected and uninfected patients in terms of gender ratio,age distribution,and tumor classification(P>0.05).The positive rate of TB-IGRA was 65.22%(15/23),the nucleic acid amplification test was 47.83%(11/23),and the T-cell monitoring of tuberculosis infection was 55.52%(13/23).When the three testing techniques were applied in combination,the positive detection rate of tuberculosis bacteria was 82.61%(19/23),which was significantly higher than that of single detection(P<005).Conclusion The TB-IGRA assay had the highest positive rate of detecting patients with tumor-combined tuberculosis infection,and the combined use of the three assays had a significantly higher positive detection rate than that of individual application,which has good clinical application value.

关 键 词：T细胞免疫斑点试验 γ-干扰素释放检测 核酸扩增检测 结核感染T细胞监测 肿瘤 结核感染 

分 类 号：R730.4[医药卫生—肿瘤] R378.911[医药卫生—临床医学]