Korean J Otorhinolaryngol-Head Neck Surg.  2013 Jun;56(6):354-358. 10.3342/kjorl-hns.2013.56.6.354.

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

• Kim JK
• Ko JJ
• Kim KC

• KMID: 2277769
• DOI: http://doi.org/10.3342/kjorl-hns.2013.56.6.354

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.

Keyword

Interferon; Lymph node; Skin test; Tuberculosis

MeSH Terms

Interferon-gamma
Interferon-gamma Release Tests
Interferons
Lymph Nodes
Polymerase Chain Reaction
Prospective Studies
Sensitivity and Specificity
Skin
Skin Tests
Tuberculin
Tuberculosis
Tuberculosis, Lymph Node
Interferon-gamma
Interferons
Tuberculin