{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:46:20Z","timestamp":1785149180896,"version":"3.55.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2017ZX10103005-007"],"award-info":[{"award-number":["2017ZX10103005-007"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81401639"],"award-info":[{"award-number":["81401639"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>Tuberculous peritonitis (TP) is a common form of abdominal tuberculosis (TB). Diagnosing TP remains challenging in clinical practice. The aim of the present meta-analysis was to evaluate the diagnostic accuracy of peripheral blood (PB) T-SPOT and peritoneal fluid (PF) T-SPOT for diagnosing TP.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold>PubMed, EmBase, Cochrane, Scopus, Google scholar, China national knowledge internet, and Wan-Fang databases were searched for relevant articles from August 1, 2005 to July 5, 2020. Statistical analysis was performed using Stata, Revman, and Meta-Disc software. Diagnostic parameters including pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were determined. Summary receiver operating characteristic curve was used to determine the area under the curve (AUC).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>Twelve studies were eligible and included in the meta-analysis. The analysis showed that the pooled sensitivity and specificity of PB T-SPOT in diagnosing TP were 0.91 (95% CI, 0.88\u20130.94) and 0.78 (95% CI, 0.73\u20130.81), respectively, while the pooled PLR, NLR, and DOR were 4.05 (95% CI, 2.73\u20136.01), 0.13 (95% CI, 0.07\u20130.23), and 37.8 (95% CI, 15.04\u201394.98), respectively. On the other hand, the summary estimates of sensitivity, specificity, PLR, NLR, and DOR of PF T-SPOT for TP diagnosis were 0.90 (95% CI, 0.85\u20130.94), 0.78 (95% CI, 0.72\u20130.83), 6.35 (95% CI, 2.67\u201315.07), 0.14 (95% CI, 0.09\u20130.21), and 58.22 (95% CI, 28.76\u2013117.83), respectively. Furthermore, the AUC of PB T-SPOT and PF T-SPOT for TP diagnosis were 0.91 and 0.94, respectively.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold>Our results indicate that both PB T-SPOT and PF T-SPOT can be served as sensitive approaches for the diagnosis of TP. However, the unsatisfactory specificities of these two methods limit their application as rule-in tests for TP diagnosis. Furthermore, the standardization of the operating procedure of PF T-SPOT is further needed.<\/jats:p>","DOI":"10.3389\/fmed.2020.585180","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T06:21:11Z","timestamp":1608704471000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Diagnostic Value of T-SPOT.TB Assay for Tuberculous Peritonitis: A Meta-Analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Ying","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyan","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoxing","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2020,12,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1016\/S0140-6736(19)30308-3","article-title":"Tuberculosis","volume":"393","author":"Furin","year":"2019","journal-title":"Lancet."},{"key":"B2","unstructured":"Global Tuberculosis Report2019"},{"key":"B3","doi-asserted-by":"publisher","first-page":"457","DOI":"10.3201\/eid2503.180572","article-title":"Epidemiology of extrapulmonary tuberculosis among inpatients, China, 2008\u20132017","volume":"25","author":"Pang","year":"2019","journal-title":"Emerg Infect Dis."},{"key":"B4","unstructured":"TB Incidence in the United States, 1953\u201320182019"},{"key":"B5","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.gcb.2010.07.023","article-title":"Peritoneal tuberculosis","volume":"35","author":"Guirat","year":"2011","journal-title":"Clin Res Hepatol Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.1086\/523727","article-title":"Diagnostic challenges of tuberculosis peritonitis in patients with and without end-stage renal failure","volume":"45","author":"Chau","year":"2007","journal-title":"Clin Infect Dis."},{"key":"B7","doi-asserted-by":"crossref","first-page":"20431","DOI":"10.2807\/ese.18.12.20431-en","article-title":"Extrapulmonary tuberculosis in the European Union and European Economic Area, 2002 to 2011","volume":"18","author":"Sandgren","year":"2013","journal-title":"Euro Surveill."},{"key":"B8","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1086\/341898","article-title":"Tuberculous peritonitis-associated mortality is high among patients waiting for the results of mycobacterial cultures of ascitic fluid samples","volume":"35","author":"Chow","year":"2002","journal-title":"Clin Infect Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1097\/00000658-197612000-00010","article-title":"Tuberculous peritonitis: 43 years' experience in diagnosis and treatment","volume":"184","author":"Dineeen","year":"1976","journal-title":"Ann Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1086\/313919","article-title":"Tuberculous peritonitis in patients undergoing continuous ambulatory peritoneal dialysis: case report and review","volume":"31","author":"Talwani","year":"2000","journal-title":"Clin Infect Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1111\/j.1365-2036.2005.02645.x","article-title":"Systematic review: tuberculous peritonitis\u2013presenting features, diagnostic strategies and treatment","volume":"22","author":"Sanai","year":"2005","journal-title":"Aliment Pharmacol Ther."},{"key":"B12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1128\/microbiolspec.TNMI7-0006-2016","article-title":"Tuberculous peritonitis","author":"Vaid","year":"2017","journal-title":"Microbiol Spectr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1111\/j.1440-1746.1992.tb00984.x","article-title":"Presentation and role of peritoneoscopy in the diagnosis of tuberculous peritonitis","volume":"7","author":"Sandikci","year":"1992","journal-title":"J Gastroenterol Hepatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s40121-016-0113-2","article-title":"Clinical presentation, diagnosis, and bacterial epidemiology of peritoneal tuberculosis in two university hospitals in France","volume":"5","author":"Cavalli","year":"2016","journal-title":"Infect Dis Ther."},{"key":"B15","doi-asserted-by":"publisher","first-page":"470","DOI":"10.4269\/ajtmh.1992.47.470","article-title":"Tuberculous peritonitis in Egypt: the value of laparoscopy in diagnosis","volume":"47","author":"Nafeh","year":"1992","journal-title":"Am J Trop Med Hyg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"517","DOI":"10.3109\/02841859609175435","article-title":"US and CT findings in the diagnosis of tuberculous peritonitis","volume":"37","author":"Demirkazik","year":"1996","journal-title":"Acta Radiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S0002-9343(97)89456-9","article-title":"Diagnostic features of tuberculous peritonitis in the absence and presence of chronic liver disease: a case control study","volume":"100","author":"Shakil","year":"1996","journal-title":"Am J Med."},{"key":"B18","first-page":"434","article-title":"Ascites in the state of qatar: aetiology and diagnostic value of ascitic fluid analysis","volume":"48","author":"Khan","year":"2007","journal-title":"Singapore Med J."},{"key":"B19","first-page":"277","article-title":"Tuberculous peritonitis. Low ascitic fluid glucose concentration as a diagnostic aid","volume":"66","author":"Brown","year":"1976","journal-title":"Am J Gastroenterol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1002\/hep.510240617","article-title":"Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States","volume":"24","author":"Hillebrand","year":"1996","journal-title":"Hepatology."},{"key":"B21","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1136\/gut.36.3.419","article-title":"Ascitic fluid gamma interferon concentrations and adenosine deaminase activity in tuberculous peritonitis","volume":"36","author":"Sathar","year":"1995","journal-title":"Gut."},{"key":"B22","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0041-3879(91)90007-F","article-title":"Diagnostic value of ascites gamma interferon levels in tuberculous peritonitis. Comparison with adenosine deaminase activity","volume":"72","author":"Ribera","year":"1991","journal-title":"Tubercle."},{"key":"B23","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3389\/fcimb.2019.00010","article-title":"The performance of pleural fluid T-SPOT","volume":"9","author":"Luo","year":"2019","journal-title":"Front Cell Infect Microbiol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.4103\/0366-6999.181958","article-title":"Diagnostic value of T-cell interferon-gamma release assays on synovial fluid for articular tuberculosis: a pilot study","volume":"129","author":"Cheng","year":"2016","journal-title":"Chin Med J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1086\/652142","article-title":"Rapid diagnosis of tuberculous meningitis by T cell-based assays on peripheral blood and cerebrospinal fluid mononuclear cells","volume":"50","author":"Kim","year":"2010","journal-title":"Clin Infect Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1016\/j.jinf.2011.04.001","article-title":"Rapid diagnosis of tuberculous peritonitis by T cell-based assays on peripheral blood and peritoneal fluid mononuclear cells","volume":"62","author":"Cho","year":"2011","journal-title":"J Infect."},{"key":"B27","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.jinf.2014.09.012","article-title":"A rapid and non-invasive 2-step algorithm for diagnosing tuberculous peritonitis using a T cell-based assay on peripheral blood and peritoneal fluid mononuclear cells together with peritoneal fluid adenosine deaminase","volume":"70","author":"Lee","year":"2015","journal-title":"J Infect."},{"key":"B28","doi-asserted-by":"publisher","first-page":"534","DOI":"10.3881\/j.issn.1000-503X.10516","article-title":"[Values of different laboratory diagnostic approaches for tuberculous peritonitis]","volume":"40","author":"Fei","year":"2018","journal-title":"Zhongguo Yi Xue Ke Xue Yuan Xue Bao."},{"key":"B29","doi-asserted-by":"publisher","first-page":"W65","DOI":"10.1371\/journal.pmed.1000100","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"151","author":"Liberati","year":"2009","journal-title":"Ann Intern Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann Intern Med"},{"key":"B31","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ."},{"key":"B32","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.jinf.2009.09.006","article-title":"Diagnosis of abdominal tuberculosis by T-cell-based assays on peripheral blood and peritoneal fluid mononuclear cells","volume":"59","author":"Kim","year":"2009","journal-title":"J Infect."},{"key":"B33","first-page":"2046","article-title":"Clinical value of T-SPOT","volume":"27","author":"Wu","year":"2012","journal-title":"Clin Focus."},{"key":"B34","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3969\/j.issn.1672-7347.2013.05.014","article-title":"[T-SPOT","volume":"38","author":"Zhou","year":"2013","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban."},{"key":"B35","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3870\/1cxh.j.issn.1005-541X.2014.01.04","article-title":"Study of T-SPOT","volume":"26","author":"Wang","year":"2014","journal-title":"Chin J Clin Gastroenterol."},{"key":"B36","first-page":"296","article-title":"The value of T-SPOT","volume":"35","author":"Wang","year":"2014","journal-title":"Sichuan Med J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e85030","DOI":"10.1371\/journal.pone.0085030","article-title":"Utility of T-cell interferon-gamma release assays for diagnosing tuberculous serositis: a prospective study in Beijing, China","volume":"9","author":"Zhang","year":"2014","journal-title":"PLoS ONE."},{"key":"B38","doi-asserted-by":"publisher","first-page":"4116","DOI":"10.11816\/cn.ni.2015-142423","article-title":"Value of T-SPOT","volume":"18","author":"Cao","year":"2015","journal-title":"Chin J Nosocomiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"3444","DOI":"10.3969\/j.issn.1002-7386.2015.22.029","article-title":"The value of the combination of T-SPOT and ADA in the diagnosis of tuberculous peritonitis","volume":"22","author":"Zhao","year":"2015","journal-title":"Hebei Med J."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2056168","DOI":"10.1155\/2020\/2056168","article-title":"Diagnostic value of interferon-gamma release assays combined with multiple indicators for tuberculous peritonitis","volume":"2020","author":"He","year":"2020","journal-title":"Gastroenterol Res Pract."},{"key":"B41","doi-asserted-by":"crossref","DOI":"10.1080\/14787210.2020.1816169","article-title":"Diagnostic accuracy of the Xpert MTB\/RIF assay for abdominal tuberculosis: a systematic review and meta-analysis","volume-title":"Expert Rev Anti Infect Ther.","author":"Sharma","year":"2020"},{"key":"B42","doi-asserted-by":"publisher","first-page":"CD012768","DOI":"10.1002\/14651858.CD012768.pub2","article-title":"Xpert((R)) MTB\/RIF assay for extrapulmonary tuberculosis and rifampicin resistance","volume":"8","author":"Kohli","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"B43","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.diagmicrobio.2013.12.010","article-title":"Diagnostic value of adenosine deaminase in ascites for tuberculosis ascites: a meta-analysis","volume":"79","author":"Tao","year":"2014","journal-title":"Diagn Microbiol Infect Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"601","DOI":"10.5114\/aoms.2013.36904","article-title":"Diagnostic accuracy of adenosine deaminase for tuberculous peritonitis: a meta-analysis","volume":"9","author":"Shen","year":"2013","journal-title":"Arch Med Sci."},{"key":"B45","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1097\/00004836-200609000-00009","article-title":"Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis","volume":"40","author":"Riquelme","year":"2006","journal-title":"J Clin Gastroenterol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.3748\/wjg.v19.i10.1645","article-title":"Assessment by meta-analysis of interferon-gamma for the diagnosis of tuberculous peritonitis","volume":"19","author":"Su","year":"2013","journal-title":"World J Gastroenterol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1183\/09031936.00005309","article-title":"Utility of quantitative T-cell responses versus unstimulated interferon-{gamma} for the diagnosis of pleural tuberculosis","volume":"34","author":"Dheda","year":"2009","journal-title":"Eur Respir J."},{"key":"B48","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1097\/MCP.0b013e32832bcc4e","article-title":"Interferon-gamma release assays for the diagnosis of TB pleural effusions: hype or real hope?","volume":"15","author":"Hooper","year":"2009","journal-title":"Curr Opin Pulmonary Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.ijid.2019.10.036","article-title":"Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB\/RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China","volume":"90","author":"Liu","year":"2020","journal-title":"Int J Infect Dis."},{"key":"B50","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1086\/426139","article-title":"Ex vivo characterization of early secretory antigenic target 6-specific T cells at sites of active disease in pleural tuberculosis","volume":"40","author":"Wilkinson","year":"2005","journal-title":"Clin Infect Dis."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1183\/09031936.00067307","article-title":"Use of a T-cell interferon-gamma release assay for the diagnosis of tuberculous pleurisy","volume":"30","author":"Losi","year":"2007","journal-title":"Eur Respir J."},{"key":"B52","doi-asserted-by":"publisher","first-page":"e214333","DOI":"10.1371\/journal.pone.0214333","article-title":"Proportions of interferon-\u03b3-producing ascites lymphocytes in response to mycobacterial antigens: a help for early diagnosis of peritoneal tuberculosis in a low TB incidence country","volume":"14","author":"Wilkinson","year":"2019","journal-title":"PLoS ONE."},{"key":"B53","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1136\/thoraxjnl-2016-209718","article-title":"Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis","volume":"73","author":"Wang","year":"2018","journal-title":"Thorax."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.3389\/fimmu.2018.01047","article-title":"The use of TB-specific antigen\/phytohemagglutinin ratio for diagnosis and treatment monitoring of extrapulmonary tuberculosis","volume":"9","author":"Wang","year":"2018","journal-title":"Front Immunol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"e00812","DOI":"10.1128\/mBio.00812-17","article-title":"The new Xpert MTB\/RIF ultra: improving detection of mycobacterium tuberculosis and resistance to rifampin in an assay suitable for point-of-care testing","volume":"8","author":"Chakravorty","year":"2017","journal-title":"MBio."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.585180\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,18]],"date-time":"2021-04-18T04:42:10Z","timestamp":1618720930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.585180\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,23]]},"references-count":55,"alternative-id":["10.3389\/fmed.2020.585180"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2020.585180","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,23]]},"article-number":"585180"}}