Diagnostic performance analysis of Xpert MTB/RIF in lymph node tuberculosis: A retrospective study

Area of Science:

• Medical Diagnostics
• Infectious Diseases
• Microbiology

Background:

• Lymph node tuberculosis (LNTB) poses diagnostic challenges.
• Accurate and rapid diagnostic tools are crucial for effective LNTB management.

Purpose of the Study:

• To evaluate the diagnostic efficacy of Xpert MTB/RIF (Xpert) for LNTB.
• To compare Xpert's performance with pathological examination and culture.

Main Methods:

• Retrospective analysis of 421 suspected LNTB cases.
• Calculation of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for Xpert, pathology, and culture.
• Analysis of Xpert's performance based on sample type and lymph node location.

Main Results:

• Xpert demonstrated higher sensitivity (72.15%) and AUC (0.861) compared to pathology (20.69%, 0.603) and culture (30.24%, 0.651).
• Xpert sensitivity was highest in pus samples (96.05%), followed by puncture fluid (74.42%) and tissue (64.73%).
• Xpert showed better sensitivity in mediastinal (84.21%) and head-and-neck (72.51%) lymph nodes compared to axillary (45.83%).

Conclusions:

• Xpert MTB/RIF is a valuable diagnostic tool for LNTB.
• Xpert offers superior diagnostic performance over conventional methods, particularly with specific sample types and locations.
• The findings support the use of Xpert for improved LNTB diagnosis.