宏基因组下一代测序在痰量稀少或痰病原学检测结果阴性的疑似肺结核患者中的诊断价值
The diagnostic value of metagenomic next-generation sequencing in suspected pulmonary tuberculosis patients with scarce sputum or negative sputum etiological test results.
作者信息
Xiong Wanfeng, Dong Liang, Zhu Ning, Zhou Daibing, Li Shuanghui, Lv Junzhu, Xu Mengqi, Zhang Yuhai, Li Shengqing
机构信息
Department of Pulmonary and Critical Care Medicine, Huashan Hospital affiliated to Fudan University, Shanghai, China.
Department of Health Statistics, Air Force Medical University, Xi'an, China.
出版信息
Diagn Microbiol Infect Dis. 2025 Mar;111(3):116633. doi: 10.1016/j.diagmicrobio.2024.116633. Epub 2024 Dec 3.
OBJECTIVE
To compare the diagnostic value between mNGS and conventional tests in suspected pulmonary tuberculosis (PTB) patients with scarce sputum or with negative sputum etiological test results.
METHODS
We enrolled eligible patients admitted to our department from 2018 to 2021. Their bronchoalveolar lavage fluid (BALF) and lung biopsy tissue samples were sent for mNGS and conventional tests. The diagnostic value of mNGS was compared respectively with that of conventional tests.
RESULTS
94 of 226 enrolled patients were diagnosed PTB. The diagnostic concordance rate of mNGS was significantly higher than that of acid-fast staining in all samples (p < 0.001), as well as that of culture in BALF samples (p = 0.011). mNGS in parallel with conventional tests had significantly higher AUC than mNGS alone (p = 0.013).
CONCLUSIONS
mNGS has higher diagnostic value than some conventional tests. mNGS in parallel with conventional tests is more reliable to accurately diagnose these suspected PTB patients.
目的
比较宏基因组下一代测序（mNGS）与传统检测方法对痰量少或痰病原学检测结果阴性的疑似肺结核（PTB）患者的诊断价值。
方法
纳入2018年至2021年在我科住院的符合条件的患者。将其支气管肺泡灌洗液（BALF）和肺活检组织样本送检进行mNGS和传统检测。分别比较mNGS与传统检测的诊断价值。
结果
226例纳入患者中94例被诊断为PTB。mNGS在所有样本中的诊断符合率显著高于抗酸染色（p<0.001），在BALF样本中也显著高于培养法（p=0.011）。mNGS与传统检测方法联合使用时的曲线下面积（AUC）显著高于单独使用mNGS（p=0.013）。
结论
mNGS比一些传统检测方法具有更高的诊断价值。mNGS与传统检测方法联合使用能更可靠地准确诊断这些疑似PTB患者。
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