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支气管灌洗宏基因组下一代测序技术在肺结核诊断中的应用

Bronchial lavage tNGS in the diagnosis of pulmonary tuberculosis.

作者信息

Yang Zhongpeng, Tang Yucong, Shan Shuxiang

机构信息

Department of Respiratory and Critical Care Medicine, Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China.

Department of Respiratory and Critical Care Medicine, Tianjin Medical University, Tianjin, China.

出版信息

Technol Health Care. 2025;33(1):215-223. doi: 10.3233/THC-240823.

Abstract

BACKGROUND

Tuberculosis (TB), primarily caused by Mycobacterium tuberculosis, remains a significant global health concern. Targeted Next-Generation Sequencing (tNGS) has emerged as a rapid and comprehensive diagnostic tool for tuberculosis, offering advantages over traditional methods and serving as an effective alternative for drug susceptibility testing and the detection of drug-resistant tuberculosis.

OBJECTIVE

This study aimed to retrospectively analyze the clinical characteristics of pulmonary tuberculosis patients. After explore the application value of targeted next-generation sequencing technology in this patient population, providing valuable insights for clinical diagnosis and treatment.

METHODS

In this retrospective study, we analyzed data from 65 patients with laboratory-confirmed tuberculosis admitted to Tianjin Baodi Hospital from November 14, 2020, to February 1, 2023. Patients underwent bronchoalveolar lavage fluid (BALF) testing, including acid-fast staining, culture, and tNGS. Biopsies and histopathological examinations were performed on some patients, along with comprehensive radiological assessments for all.

RESULTS

Among the 65 pulmonary tuberculosis patients, targeted next-generation sequencing detected pathogens in bronchoalveolar lavage fluid with a positivity rate of 93.8%, significantly higher than traditional methods such as acid-fast staining, culture, and pathology. Compared to bronchoalveolar lavage fluid smear, targeted next-generation sequencing demonstrated significantly higher diagnostic sensitivity (98.46% vs. 26.15%) and accuracy (98.46% vs. 26.15%).

CONCLUSION

Targeted next-generation sequencing, with its high sensitivity and specificity compared to traditional methods, provides unique advantages in detecting pathogens among these patients, highlighting its importance in disease management.

摘要

背景

结核病主要由结核分枝杆菌引起,仍然是全球重大的健康问题。靶向新一代测序(tNGS)已成为一种快速且全面的结核病诊断工具,与传统方法相比具有优势,可作为药物敏感性测试和耐药结核病检测的有效替代方法。

目的

本研究旨在回顾性分析肺结核患者的临床特征。探索靶向新一代测序技术在该患者群体中的应用价值,为临床诊断和治疗提供有价值的见解。

方法

在这项回顾性研究中,我们分析了2020年11月14日至2023年2月1日入住天津市宝坻医院的65例实验室确诊结核病患者的数据。患者接受了支气管肺泡灌洗(BALF)检测,包括抗酸染色、培养和tNGS。对部分患者进行了活检和组织病理学检查,对所有患者进行了全面的影像学评估。

结果

在65例肺结核患者中,靶向新一代测序在支气管肺泡灌洗中检测到病原体的阳性率为93.8%,显著高于抗酸染色、培养和病理学等传统方法。与支气管肺泡灌洗涂片相比,靶向新一代测序显示出显著更高的诊断敏感性(98.46%对26.15%)和准确性(98.46%对26.15%)。

结论

与传统方法相比,靶向新一代测序具有高敏感性和特异性,在这些患者中检测病原体方面具有独特优势,凸显了其在疾病管理中的重要性。

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