Jha Himanshu, Baveja Chandra Prakash, Kamal Vinay, Agarwal Prem Narayan, Saxena Sonal, Dhakad Megh Singh, Sharma Divakar
Department of Microbiology, Maulana Azad Medical College, New Delhi 110002, India.
Lab Strengthening & Diagnostics, Jhpiego, India.
Can J Infect Dis Med Microbiol. 2023 Jun 13;2023:3312250. doi: 10.1155/2023/3312250. eCollection 2023.
The study included 100 clinically suspected cases of TBLN. Fine needle aspirate (FNA) samples were processed for cytology staining and cultured on LJ & BACTEC 12B media. The biochemical tests were performed to identify the isolates at the species level. Additionally, for PCR, DNA was extracted and used for the diagnosis and identification of mycobacterial species.
Patients ranged from 2 to 45 years with a mean age of 24.96 ± 9.10 years. Out of 100 patients, 73% had clinical symptoms of weight loss, followed by fever (72%), anorexia (66%), and night sweats (58%). 24% of patients were found to be smear-positive after Ziehl-Neelsen (ZN) staining and statistically highly significant with PCR. On LJ medium 34% and on BACTEC radiometric 45% of samples were smearing positive. Overall, 48% of cases were PCR-positive for TBLN. When compared with culture, the sensitivity and specificity of PCR were 93.75% and 100%, respectively, which are higher than cytology. The true positive predictive value (PPV) and negative predictive value (NPV) were 83.3% and 61.5%, respectively.
This study suggests that PCR is a rapid, sensitive, and specific tool for correct diagnosis of TBLN cases as compared to staining and culture which lead to the early and proper management of mycobacterial diseases.
该研究纳入了100例临床疑似支气管淋巴结结核（TBLN）病例。对细针穿刺抽吸（FNA）样本进行细胞学染色处理，并在罗-琴（LJ）培养基和BACTEC 12B培养基上培养。进行生化试验以在种水平鉴定分离株。此外，对于聚合酶链反应（PCR），提取DNA并用于分枝杆菌种的诊断和鉴定。
患者年龄在2至45岁之间，平均年龄为24.96±9.10岁。在100例患者中，73%有体重减轻的临床症状，其次是发热（72%）、厌食（66%）和盗汗（58%）。24%的患者经萋-尼（ZN）染色后涂片阳性，与PCR结果相比具有统计学高度显著性。在LJ培养基上34%的样本涂片阳性，在BACTEC放射性培养基上45%的样本涂片阳性。总体而言，48%的TBLN病例PCR阳性。与培养相比，PCR的敏感性和特异性分别为93.75%和100%，高于细胞学检查。真阳性预测值（PPV）和真阴性预测值（NPV）分别为83.3%和61.5%。
本研究表明，与染色和培养相比，PCR是一种快速、敏感且特异的工具，可用于正确诊断TBLN病例，从而实现分枝杆菌病的早期和恰当管理。
