Zhou Lihong, Yong Yan, Li Hao, Hu Qin
Zhejiang Tuberculosis Diagnosis and Treatment Center, Zhejiang Chinese and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People's Republic of China.
Tuberculosis Laboratory, Zhejiang Chinese and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, People's Republic of China.
Infect Drug Resist. 2024 Oct 25;17:4685-4693. doi: 10.2147/IDR.S476732. eCollection 2024.
The diagnosis of tuberculosis located in the peripheral zone remains challenging and requires ultrasound bronchoscopy-guided maneuvers. We assessed the precision of CapitalBio nucleic acid detection test (CapitalBio MTB test) and isothermal RNA amplification test (MTB-RNA) using endobronchial ultrasonography with a guide sheath (EBUS-GS) for peripheral pulmonary tuberculosis (PTB) and compared it with those of acid-fast bacilli (AFB) smear and MTB culture tests.
This retrospective analysis included 287 patients suspected of peripheral pulmonary tuberculosis who underwent EBUS-GS examinations, medical examination results of AFB smears, MTB culture, CapitalBio MTB test, and MTB-RNA were analyzed. We evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC), and its diagnostic accuracy for peripheral PTB was evaluated in comparison with the final clinical diagnosis.
The overall sensitivity, specificity, PPV, NPV, and AUC of CapitalBio MTB test were 44.83%, 100.00%, 100.00%, 54.07%, and 0.72, respectively; those of MTB-RNA were 22.99%, 100.00%, 100.00%, 45.75%, and 0.61, respectively, and those for parallel test (CapitalBio MTB test or MTB-RNA) were 46.55%, 100.00%, 100.00%, 54.85%, and 0.73, respectively. These values for AFB smear were 9.2%, 97.35%, 84.21%, 41.04%, and 0.53, respectively, and those of MTB culture were 31.03%, 100.00%, 100.00%, 48.50%, and 0.69, respectively.
The CapitalBio MTB test showed the best diagnostic performance compared with AFB smear, MTB culture, and MTB-RNA assays and was similar to the parallel test (CapitalBio MTB test or MTB-RNA). The CapitalBio MTB test combined with EBUS-GS had satisfactory diagnostic accuracy for diagnosing peripheral PTB.
外周区域肺结核的诊断仍然具有挑战性，需要超声支气管镜引导操作。我们评估了博奥生物核酸检测试验（博奥生物结核杆菌检测）和等温RNA扩增试验（MTB-RNA）在使用带引导鞘的支气管内超声（EBUS-GS）诊断外周型肺结核（PTB）中的准确性，并将其与抗酸杆菌（AFB）涂片和MTB培养试验的准确性进行比较。
这项回顾性分析纳入了287例疑似外周型肺结核且接受了EBUS-GS检查的患者，分析了AFB涂片、MTB培养、博奥生物结核杆菌检测和MTB-RNA的医学检查结果。我们评估了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）以及受试者操作特征曲线下面积（AUC），并与最终临床诊断相比较评估其对外周型PTB的诊断准确性。
博奥生物结核杆菌检测的总体敏感性、特异性、PPV、NPV和AUC分别为44.83%、100.00%、100.00%、54.07%和0.72；MTB-RNA的分别为22.99%、100.00%、100.00%、45.75%和0.61，平行试验（博奥生物结核杆菌检测或MTB-RNA）的分别为46.55%、100.00%、100.00%、54.85%和0.73。AFB涂片的这些值分别为9.2%、97.35%、84.21%、41.04%和0.53，MTB培养的分别为31.03%、100.00%、100.00%、48.50%和0.69。
与AFB涂片、MTB培养和MTB-RNA检测相比，博奥生物结核杆菌检测显示出最佳的诊断性能，且与平行试验（博奥生物结核杆菌检测或MTB-RNA）相似。博奥生物结核杆菌检测联合EBUS-GS对外周型PTB的诊断具有令人满意的准确性。
