Liu Bingbing, Yu Tengfei, Ren Ruotong, Wu Na, Xing Nanshu, Wang Jingya, Wu Wenjie, Cao Xuefang, Zhang Jingping
Department of Infectious Diseases, The First Hospital of China Medical University, Shenyang, 110001, China.
Institute of Innovative Applications, MatriDx Biotechnology Co., Ltd, Hangzhou, 311112, China.
BMC Infect Dis. 2024 Dec 28;24(1):1475. doi: 10.1186/s12879-024-10383-3.
Delayed diagnosis of patients with Fever of Unknown Origin has long been a daunting clinical challenge. Onco-mNGS, which can accurately diagnose infectious agents and identify suspected tumor signatures by analyzing host chromosome copy number changes, has been widely used to assist identifying complex etiologies. However, the application of Onco-mNGS to improve FUO etiological screening has never been studied before.
In this single-centre prospective study, we included 65 patients with classic FUO, who were randomly divided into control group (sample cultivation) and mNGS group (cultivation + Onco-mNGS). We analyzed the infectious agents and symbiotic microbiological, tumor and clinical data of both groups.
Infection-related pathogenic detection efficiency rose from 25% (control group) to 48.48% (experimental group). Seven patients with chromosome copy number changes had later been confirmed tumors, indicating a 100% of clinical concordance rate of Onco-mNGS for tumors. In addition, the time frame for diagnosing or ruling out infection/tumor with Onco-mNGS had greatly reduced to approximately 2 days, which was 7.34 days earlier than that in the control group.
Onco-mNGS is an ideal rapid diagnostic aid to assist improving the early diagnostic efficiency of FUO-associated diseases.
长期以来，不明原因发热患者的延迟诊断一直是一项艰巨的临床挑战。肿瘤多组学下一代测序（Onco-mNGS）能够通过分析宿主染色体拷贝数变化准确诊断感染因子并识别可疑肿瘤特征，已被广泛用于辅助识别复杂病因。然而，此前从未研究过应用Onco-mNGS来改善不明原因发热的病因筛查。
在这项单中心前瞻性研究中，我们纳入了65例经典不明原因发热患者，将其随机分为对照组（样本培养）和mNGS组（培养+Onco-mNGS）。我们分析了两组的感染因子、共生微生物、肿瘤及临床数据。
感染相关病原体检测效率从25%（对照组）提高到48.48%（实验组）。7例染色体拷贝数变化的患者后来被确诊为肿瘤，表明Onco-mNGS对肿瘤的临床符合率为100%。此外，使用Onco-mNGS诊断或排除感染/肿瘤的时间大幅缩短至约2天，比对照组早7.34天。
Onco-mNGS是一种理想的快速诊断辅助手段，有助于提高不明原因发热相关疾病的早期诊断效率。
