宏基因组下一代测序在结核病诊断中的临床应用。
Clinical application of metagenomic next-generation sequencing in tuberculosis diagnosis.
机构信息
Gene Hospital of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
Front Cell Infect Microbiol. 2023 Mar 28;12:984753. doi: 10.3389/fcimb.2022.984753. eCollection 2022.
OBJECTIVE
The purpose of this study was to evaluate the clinical diagnostic value of metagenomic next-generation sequencing (mNGS) for tuberculosis (TB).
METHODS
This retrospective study included 52 patients with suspected TB infection. mNGS, targeted PCR, acid-fast staining and, T-SPOT.TB assay were performed on the specimen. The positive rate of mNGS and traditional detection methods was statistically analyzed. Pathological tests were performed when necessary.
RESULTS
In total, 52 patients with suspected of TB in this study were included in the analysis, and 31 patients were finally diagnosed with TB. Among 52 patients, 14 (26.9%) cases were positive for acid-fast staining. The positive rate of T-SPOT.TB assay in 52 patients was 73.1% (38/52). Among 52 patients, 39 (75%) were detected positive for (TB) by mNGS. Regarding the detection rate of MTB, mNGS were as high as 75% (39/52), whereas acid-resistant staining was only 26.9% (14/52), which showed a statistically significant difference (p<0.05). The positive rates of T-SPOT.TB assay and mNGS were not statistically significant (p>0.05). Of the 52 suspected TB patients, 24 had targeted PCR, of which 18 were PCR positive. In 24 patients, the positive rate of PCR was 75%, and the positive rate of mNGS was 100%, with statistical difference between them (p<0.05).
CONCLUSIONS
The detection rate of MTB by mNGS was higher than that by conventional acid-fast staining and PCR, but not statistically significant compared with T-SPOT.TB assay. As an adjunctive diagnostic technology, mNGS can be combined with traditional detection methods to play a guiding role in the diagnosis and treatment of TB.
目的
本研究旨在评估宏基因组下一代测序（mNGS）在结核病（TB）临床诊断中的价值。
方法
本回顾性研究纳入了 52 例疑似 TB 感染患者。对标本进行 mNGS、靶向 PCR、抗酸染色和 T-SPOT.TB 检测。统计分析 mNGS 和传统检测方法的阳性率。必要时进行病理检查。
结果
本研究共纳入 52 例疑似 TB 患者，最终诊断为 TB 的患者有 31 例。52 例患者中，14 例（26.9%）抗酸染色阳性。52 例患者 T-SPOT.TB 检测阳性率为 73.1%（38/52）。52 例患者中，39 例（75%）mNGS 检测 MTB 阳性。mNGS 检测 MTB 的检出率高达 75%（39/52），而抗酸染色仅为 26.9%（14/52），差异有统计学意义（p<0.05）。T-SPOT.TB 检测和 mNGS 的阳性率差异无统计学意义（p>0.05）。52 例疑似 TB 患者中，有 24 例行靶向 PCR 检测，其中 18 例 PCR 阳性。24 例患者中，PCR 阳性率为 75%，mNGS 阳性率为 100%，差异有统计学意义（p<0.05）。
结论
mNGS 检测 MTB 的检出率高于传统抗酸染色和 PCR，但与 T-SPOT.TB 检测相比，差异无统计学意义。作为一种辅助诊断技术，mNGS 可与传统检测方法相结合，对 TB 的诊断和治疗起到指导作用。
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