Song Chang, Zhao Chunyan, Lin Yanrong, Nong Yingxing, Huang Aichun, Xi Shaoyong, Wei Xiaoying, Zeng Chunmei, Yang Shixiong, Zhu Qingdong
Department of Tuberculosis, The Fourth People's Hospital of Nanning, Nanning, China.
Guangxi Medical University, Nanning, China.
Front Cell Infect Microbiol. 2025 Jan 7;14:1432446. doi: 10.3389/fcimb.2024.1432446. eCollection 2024.
This study aimed to explore the accuracy of third-generation nanopore sequencing to diagnose extrapulmonary tuberculosis (EPTB).
Samples were collected from the lesions of 67 patients with suspected EPTB admitted between April 2022 and August 2023. Nanopore sequencing, acid-fast bacilli (AFB) staining, DNA testing, and X-pert and mycobacterial cultures were performed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUC) were calculated for different diagnostic methods, and their diagnostic accuracies were compared.
Nanopore sequencing demonstrated the highest correct diagnosis rate among 50 positive EPTB cases, independently diagnosing 19 positive cases missed by conventional methods. Its sensitivity (62.00%), specificity (94.10%), PPV (96.90%), NPV (45.70%) and AUC (0.781, 95% CI: 0.67-0.89) were superior to those of conventional methods, such as AFB staining, DNA testing, X-pert, and solid culture, indicating its significantly efficient advantage in EPTB detection.
Nanopore sequencing technology significantly outperforms conventional methods such as AFB staining, DNA testing, X-pert, and mycobacterial culture to diagnose EPTB, promising to improve the diagnosis of EPTB.
本研究旨在探讨第三代纳米孔测序诊断肺外结核（EPTB）的准确性。
收集了2022年4月至2023年8月期间收治的67例疑似EPTB患者病变部位的样本。进行了纳米孔测序、抗酸杆菌（AFB）染色、DNA检测、Xpert检测和分枝杆菌培养。计算了不同诊断方法的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和受试者工作特征曲线下面积（AUC），并比较了它们的诊断准确性。
在50例EPTB阳性病例中，纳米孔测序的正确诊断率最高，独立诊断出19例常规方法漏诊的阳性病例。其敏感性（62.00%）、特异性（94.10%）、PPV（96.90%）、NPV（45.70%）和AUC（0.781，95%CI：0.67-0.89）均优于AFB染色、DNA检测、Xpert检测和固体培养等常规方法，表明其在EPTB检测中具有显著高效的优势。
纳米孔测序技术在诊断EPTB方面明显优于AFB染色、DNA检测、Xpert检测和分枝杆菌培养等常规方法，有望改善EPTB的诊断。
