Zhang Jinjuan, Bu Caifang, Yao Liwei, Xu Kan
Department of Nursing, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Infect Drug Resist. 2023 Mar 30;16:1875-1883. doi: 10.2147/IDR.S405868. eCollection 2023.
To assess the accuracy of the (MTB)-RNA assay using pericardial tissue specimens for tuberculous pericarditis (TBP) diagnosis.
MTB culture and MTB-RNA assay were performed for patients with suspected TBP. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of these two assays were analyzed.
This study included 79 patients. The sensitivity, specificity, PPV, NPV, and AUC were 28.1% (18/64), 100.0% (15/15), 100.0% (18/18), 24.6% (15/61), and 0.64 for the MTB culture and 37.5% (24/64), 100.0% (15/15), 100.0% (24/24), 27.3% (15/55), and 0.69 for the MTB-RNA assay, respectively. Patients with positive pericardial tissue culture were defined as having definite TBP; in other words, culture was the gold standard for this group of patients and had a sensitivity, specificity, PPV, and NPV of 100% and an AUC of 1.00. However, these values were found to be 72.2% (13/18), 100.0% (15/15), 100.0% (13/13), 75.0% (15/20), and 0.86 for the MTB-RNA assay, respectively. Among patients with probable TBP (culture-negative patients), the sensitivity, specificity, NPV, and AUC of MTB culture were 0.0% (0/46), 100.0% (15/15), 24.6% (15/61), and 0.50, respectively, but the PPV could not be determined. These values were found to be 23.9% (11/46), 100.0% (15/15), 100.0% (11/11), 30.0% (15/50), and 0.62 for the MTB-RNA assay, respectively.
MTB-RNA assay using pericardial tissues had limited diagnostic efficacy for TBP. In culture-positive TBP, the diagnostic accuracy of MTB-RNA was good. In contrast, in culture-negative TBP, its diagnostic accuracy was unsatisfactory.
评估使用心包组织标本进行结核分枝杆菌（MTB）-RNA检测对结核性心包炎（TBP）诊断的准确性。
对疑似TBP患者进行MTB培养和MTB-RNA检测。分析这两种检测方法的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。
本研究纳入79例患者。MTB培养的敏感性、特异性、PPV、NPV和AUC分别为28.1%（18/64）、100.0%（15/15）、100.0%（18/18）、24.6%（15/61）和0.64，MTB-RNA检测的相应值分别为37.5%（24/64）、100.0%（15/15）、100.0%（24/24）、27.3%（15/55）和0.69。心包组织培养阳性的患者被定义为患有确诊的TBP；换句话说，培养是这组患者的金标准，其敏感性、特异性、PPV和NPV均为100%，AUC为1.00。然而，MTB-RNA检测的这些值分别为72.2%（13/18）、100.0%（15/15）、100.0%（13/13）、75.0%（15/20）和0.86。在可能患有TBP的患者（培养阴性患者）中，MTB培养的敏感性、特异性、NPV和AUC分别为0.0%（0/46）、100.0%（15/15）、24.6%（15/61）和0.50，但PPV无法确定。MTB-RNA检测的这些值分别为23.9%（11/46）、100.0%（15/15）、100.0%（11/11）、30.0%（15/50）和0.62。
使用心包组织进行MTB-RNA检测对TBP的诊断效能有限。在培养阳性的TBP中，MTB-RNA的诊断准确性良好。相比之下，在培养阴性的TBP中，其诊断准确性不令人满意。
