肺内膜超声导向跨支气管镜肺活检的诊断效果,用于识别结核结节
Xingwu Zou1, Hanmin Xu2, Qin Hu1
1Tuberculosis Department, Hangzhou Red Cross Hospital, Hangzhou, 310000, P.R. China.
BMC infectious diseases
|August 26, 2024
概括
肺内支气管超声导向的横支气管透视肺活检 (EBUS-TBLB) 是有效的诊断肺结节. 将Xpert MTB/RIF与下一代测序 (NGS) 结合起来,为肺结核 (PTB) 提供了最高的诊断疗效.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 诊断成像 诊断成像 诊断成像
背景情况:
- 肺结核 (PTB) 的微生物学诊断面临挑战,包括低病原体负担和不可靠的样.
- 内支气管超声导向的横支气管肺活检 (EBUS-TBLB) 对肺内结节的评估有希望,但其在PTB诊断中的实用性需要进一步评估.
- 本研究研究EBUS-TBLB用于诊断肺结核病的成年患者怀疑肺内结核结节.
研究的目的:
- 评估EBUS-TBLB在放射学上怀疑肺内结核结节的成年患者的诊断性能.
- 为了比较各种微生物学测试的疗效,包括下一代测序 (NGS) 和Xpert MTB/RIF,用于诊断PTB.
- 确定PTB诊断方法的最佳组合.
主要方法:
- 对107名患有肺结节的成年患者进行了回顾性分析,这些患者接受了EBUS-TBLB.
- 样品使用酸速涂抹,Bactec MGIT 960,Xpert MTB/RIF,NGS,TB-DNA和TB-RNA进行了测试.
- 使用kappa一致性分析和ROC曲线分析一致性和诊断疗效.
主要成果:
- 在EBUS-TBLB中,肺结节的整体诊断率达到80.37%.
- 下一代测序 (NGS) 显示了与临床诊断 (78.50%, κ=0.558) 的最高一致性和PTB的诊断疗效 (AUC=0.778).
- 在Xpert MTB/RIF和NGS的组合中,获得了PTB的最高一致性 (84.11%, κ=0.667) 和诊断疗效 (AUC=0.826).
结论:
- EBUS-TBLB是一种敏感且安全的诊断病理性肺结节的程序.
- 结合Xpert MTB/RIF和NGS,为PTB提供了最高的诊断效果.
- 这种综合方法被推用于肺结核的初始诊断.
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