Ahmad Raheel, Changeez Mehwish, Khan Jahangir S, Qureshi Usman, Tariq Maham, Malik Sara, Ahmad Sheikh Haseeb, Shafique Muhammad Salman
Surgery, Holy Family Hospital, Rawalpindi, PAK.
Cureus. 2018 Oct 15;10(10):e3451. doi: 10.7759/cureus.3451.
Background The diagnosis of abdominal tuberculosis is a major health challenge. Limited data are available to support the use of GeneXpert MTB/RIF in the diagnosis of abdominal tuberculosis. The current study is an analysis of the sensitivity and specificity of GeneXpert MTB/RIF for the diagnosis of abdominal tuberculosis, keeping histopathology as the gold standard. Materials and methods A prospective study was conducted in Surgery Unit-I of Holy Family hospital in the year 2017. Data of 21 patients presenting with abdominal tuberculosis were collected. The samples collected were ascitic fluid for GeneXpert and acid-fast bacilli (AFB) and a tissue sample for histopathology, which included either the enlarged lymph nodes or the involved gut segment. Results Out of a total of 21 patients, 10 were male and 11 were female. The predominant age group was less than 30 years with 76.2% cases. Of the 21 samples analyzed, all were positive for tuberculosis (TB) by histopathology. GeneXpert was positive in six and negative in 15 patients. The sensitivity of GeneXpert was 28.57% and specificity was 0%. The positive predictive value was 100%. The diagnostic accuracy was found to be 28.57%. Conclusion In our study, GeneXpert has shown poor sensitivity and specificity for the detection of abdominal TB from ascitic fluid samples. On the basis of this data, we lay stress on finding new tests and biomarkers for the rapid diagnosis of abdominal TB.
腹部结核的诊断是一项重大的健康挑战。目前支持在腹部结核诊断中使用GeneXpert MTB/RIF的可用数据有限。本研究旨在分析以组织病理学为金标准时,GeneXpert MTB/RIF诊断腹部结核的敏感性和特异性。
2017年在圣家医院外科一室进行了一项前瞻性研究。收集了21例腹部结核患者的数据。采集的样本包括用于GeneXpert检测和抗酸杆菌(AFB)检测的腹水样本,以及用于组织病理学检查的组织样本,包括肿大的淋巴结或受累的肠段。
21例患者中,男性10例,女性11例。主要年龄组为30岁以下,占76.2%。在分析的21个样本中,组织病理学检查显示所有样本结核(TB)均呈阳性。GeneXpert检测中,6例呈阳性,15例呈阴性。GeneXpert的敏感性为28.57%,特异性为0%。阳性预测值为100%。诊断准确性为28.57%。
在我们的研究中,GeneXpert在从腹水样本中检测腹部结核方面显示出较差的敏感性和特异性。基于这些数据,我们强调需要寻找新的检测方法和生物标志物以快速诊断腹部结核。