Sun Wen-Wen, Sun Qin, Yan Li-Ping, Zhang Qing
Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Oncotarget. 2017 Feb 25;8(34):57537-57542. doi: 10.18632/oncotarget.15734. eCollection 2017 Aug 22.
Here, we evaluated the potential activity of rapid detection with loop-mediated isothermal amplification (LAMP), for the early diagnosis of tuberculous meningitis (TBM). Patients with suspected TBM from January 2014 to December 2015 were reviewed retrospectively. The cerebrospinalfluid(CSF) was collected. Acid-fast bacillus (AFB) staining, MGIT 960 culture, real-time fluorescent quantitative polymerase chain reaction (RTFQ PCR) and LAMP were performed. A total of 200 patients were included in the study. Of which, 172 of them were diagnosed with TBM (86.00%). The sensitivities of AFB staining, MGIT 960 culture, LAMP and RTFQ PCR for TBM diagnosis were 2.91% (5/172), 12.79% (22/172), 43.02% (74/172), and 34.30% (59/172), respectively. The sensitivity of LAMP for TBM was significantly higher than those of AFB staining and MGIT960 culture ( = 75.11, < 0.001; = 43.88, = 0.002). LAMP's sensitivity was however comparable to RTFQ PCR assay ( = 2.08, = 0.130). The specificity, positive predictive value and negative predictive value of LAMP in the diagnosis of TBM were 92.86% (26/28), 97.37% (74/76) and 20.97 % (26/124), respectively. The overall consistency between LAMP and RTFQ PCR in the diagnosis of TBM was 88.5% (177/200), with Kappa value of 0.870. The consistency between LAMP and MGIT960 culture was 71% (142/200), with Kappa value of 0.730. Among all the methods, LAMP had high sensitivity, specificity and positive predictive value, showing high consistency with MGIT960 culture and RTFQ PCR.
在此，我们评估了环介导等温扩增技术（LAMP）用于结核性脑膜炎（TBM）早期诊断的快速检测潜在活性。对2014年1月至2015年12月疑似TBM的患者进行回顾性分析。收集脑脊液（CSF），进行抗酸杆菌（AFB）染色、MGIT 960培养、实时荧光定量聚合酶链反应（RTFQ PCR）和LAMP检测。本研究共纳入200例患者，其中172例被诊断为TBM（86.00%）。AFB染色、MGIT 960培养、LAMP和RTFQ PCR诊断TBM的敏感性分别为2.91%（5/172）、12.79%（22/172）、43.02%（74/172）和34.30%（59/172）。LAMP诊断TBM的敏感性显著高于AFB染色和MGIT 960培养（χ² = 75.11，P < 0.001；χ² = 43.88，P = 0.002）。然而，LAMP的敏感性与RTFQ PCR检测相当（χ² = 2.08，P = 0.130）。LAMP诊断TBM的特异性、阳性预测值和阴性预测值分别为92.86%（26/28）、97.37%（74/76）和20.97%（26/124）。LAMP与RTFQ PCR诊断TBM的总体一致性为88.5%（177/200），Kappa值为0.870。LAMP与MGIT 960培养的一致性为71%（142/200），Kappa值为0.730。在所有方法中，LAMP具有较高的敏感性、特异性和阳性预测值，并与MGIT 960培养及RTFQ PCR显示出高度一致性。
