使用脊髓组织的宏基因组下一代测序在脊柱结核快速诊断中的临床价值
Clinical Value of Metagenomic Next-Generation Sequencing Using Spinal Tissue in the Rapid Diagnosis of Spinal Tuberculosis.
作者信息
Jin Yanghui, Hu Shengping, Feng Junkai, Ni Jianjun
机构信息
Department of Orthopaedics, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
出版信息
Infect Drug Resist. 2023 May 29;16:3305-3313. doi: 10.2147/IDR.S410914. eCollection 2023.
PURPOSE
To evaluate the accuracy of metagenomic next-generation sequencing (mNGS) for rapid diagnosis of spinal tuberculosis using spinal tissue specimens.
METHODS
Medical data regarding suspected spinal tuberculosis were retrospectively analyzed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of mNGS were calculated to determine its diagnostic efficacy, and these values were compared with culture and composite reference standard (CRS).
RESULTS
Two hundred and three cases of spinal tuberculosis were included for analysis. The sensitivity, specificity, PPV, NPV, and AUC of mNGS compared with culture were all very good. When CRS was used for the comparison, the sensitivity of mNGS and culture were 71.2% and 73.0%; the specificity and PPV were 100% in all cases; the NPV were 74.2% and 75.4%; the AUCs were all 0.86. The sensitivity and NPV of culture were slightly higher than that of mNGS; however, the diagnostic efficacy of mNGS and culture was consistent (P > 0.05).
CONCLUSION
Spinal tissue specimens for mNGS testing had very good accuracy for diagnosing spinal tuberculosis.
目的
评估宏基因组下一代测序（mNGS）利用脊柱组织标本快速诊断脊柱结核的准确性。
方法
对疑似脊柱结核的医学数据进行回顾性分析。计算mNGS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）以确定其诊断效能，并将这些值与培养及综合参考标准（CRS）进行比较。
结果
纳入203例脊柱结核病例进行分析。与培养相比，mNGS的敏感性、特异性、PPV、NPV和AUC均非常好。当与CRS进行比较时，mNGS和培养的敏感性分别为71.2%和73.0%；所有病例的特异性和PPV均为100%；NPV分别为74.2%和75.4%；AUC均为0.86。培养的敏感性和NPV略高于mNGS；然而，mNGS和培养的诊断效能一致（P>0.05）。
结论
用于mNGS检测的脊柱组织标本对诊断脊柱结核具有很高的准确性。
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