Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095, Wuhan 430030, China.
Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095, Wuhan 430030, China.
Int J Infect Dis. 2018 Jun;71:14-19. doi: 10.1016/j.ijid.2018.01.030. Epub 2018 Feb 8.
Limited data on the diagnostic accuracy of the Xpert MTB/RIF assay using bronchoalveolar lavage fluid from patients with suspected pulmonary tuberculosis (PTB) have been reported in China. Therefore, a retrospective study was designed to evaluate the diagnostic accuracy of this assay.
Clinical, radiological, and microbiological characteristics of 238 patients with suspected PTB were reviewed retrospectively. The sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of active PTB were calculated for the Xpert MTB/RIF assay using TB culture or final diagnosis based on clinical and radiological evaluation as the reference standard.
The sensitivity and specificity of the Xpert MTB/RIF assay were 84.5% and 98.9%, respectively, and those for smear microscopy were 36.2% and 100%, respectively, when compared to the culture method. However, compared with the sensitivity and specificity of final diagnosis based on clinical and radiological evaluation, the sensitivity and specificity of the assay were 72.9% and 98.7%, respectively, which were significantly higher than those for smear microscopy.
The Xpert MTB/RIF assay on bronchoalveolar lavage fluid could serve as an additional rapid diagnostic tool for PTB in a high TB-burden country and improve the time to TB treatment initiation in patients with PTB.
在中国，有关 Xpert MTB/RIF 检测法（简称 Xpert）对疑似肺结核（简称 PTB）患者支气管肺泡灌洗液（简称 BALF）的诊断准确性的数据有限。因此，设计了一项回顾性研究来评估该检测法的诊断准确性。
回顾性分析了 238 例疑似 PTB 患者的临床、影像学和微生物学特征。以 TB 培养或基于临床和影像学评估的最终诊断为参照标准，计算 Xpert 对活动性 PTB 的诊断的灵敏度、特异度、阳性预测值和阴性预测值。
与培养方法相比，Xpert 的灵敏度和特异度分别为 84.5%和 98.9%，而涂片镜检的灵敏度和特异度分别为 36.2%和 100%。然而，与基于临床和影像学评估的最终诊断的灵敏度和特异度相比，该检测法的灵敏度和特异度分别为 72.9%和 98.7%，明显高于涂片镜检。
Xpert 对 BALF 的检测可作为高结核负担国家中 PTB 的一种额外的快速诊断工具，并可缩短 PTB 患者开始抗结核治疗的时间。
