The application value of different laboratory detection technologies in the diagnosis of lung tuberculosis

doi:10.20199/j.issn.1672-2302.2024.05.010

Abstract

Abstract:

Objective To analyze the value of different laboratory test technologies in the diagnosis of pulmonary tuberculosis so as to provide a basis for application of different detection technologies in clinical diagnosis and treatment of this infection. Methods Suspected tuberculosis patients who received treatment at Anhui Provincial Chest Hospital from January to August 2023 were selected, sputum specimens were collected for acid-fast bacilli smear, isolation culture, Mycobacterium tuberculosis DNA (TB-DNA), RNA (TB-RNA) and GeneXpert MTB/RIF detection. Blood specimens were harvested for TSPOT-TB and TB-Ab detection. The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of the seven technologies were compared, and receiver operating characteristic curve (ROC) was drawn to calculate the area under the curve (AUC). Results A total of 191 suspected tuberculosis patients were included in this study. The sensitivity (74.17%), negative predictive value (63.95%) and Youden index (0.516 3) of TSPOT-TB were the highest when the seven technologies were separately used, and the GeneXpert MTB/RIF assay had the highest specificity (100.00%) and positive predictive value (100.00%). Combined use of TSPOT-TB and TB-Ab led the highest sensitivity (91.67%), and the specificity (94.37%), positive predictive value (94.44%), negative predictive value (94.37%) and Youden index (0.510 4) were the highest when TB-DNA, TB-RNA and GeneXpert MTB/RIF were jointly detected. TSPOT-TB had the highest AUC (0.758) when used alone, TB-DNA, TB-RNA and GeneXpert MTB/RIF assays had the highest AUC (0.755) when used in combination. Conclusion All the 7 laboratory technologies are effective in the diagnosis of pulmonary tuberculosis, yet TSPOT-TB produces the highest specificity, sensitivity and Youden index. In clinical settings, either of the single test or combined tests can be optional to achieve the best detection effect.

Key words: Pulmonary tuberculosis, Laboratory detection, Sensitivity, Specificity

CLC Number:

R521，R44

YANG Jing, CHEN Yexin, XIA Guangxiu, LIN Yuhong, LI Jun, XU Dongfang, LI Yue, DING Yunsheng, BAO Xundi. The application value of different laboratory detection technologies in the diagnosis of lung tuberculosis[J]. Journal of Tropical Diseases and Parasitology, 2024, 22(5): 306-310.

Figures/Tables 3

Table 1

Table 2

Figure 1

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检测技术	灵敏度（%）	特异度（%）	阳性预测值（%）	阴性预测值（%）	约登指数	AUC（95%CI）值	P值
单一检测
TSPOT-TB	74.17	77.46	84.76	63.95	0.516 3	0.758（0.686，0.830）	<0.01
TB-Ab	55.83	63.38	72.43	45.92	0.192 1	0.596（0.513，0.679）	<0.05
抗酸染色涂片	17.50	97.18	91.30	41.07	0.146 8	0.573（0.492，0.655）	>0.05
分枝杆菌分离培养	55.00	85.92	86.84	53.04	0.409 2	0.705（0.630，0.779）	<0.01
TB-DNA	38.33	95.77	93.88	47.89	0.341 0	0.671（0.595，0.746）	<0.01
TB-RNA	30.83	98.59	97.37	45.75	0.294 2	0.647（0.571，0.724）	<0.01
GeneXpert MTB/RIF	49.17	100.00	100.00	53.79	0.491 7	0.746（0.678，0.813）	<0.01
联合检测
TSPOT-TB+TB-Ab	91.67	47.89	74.83	77.27	0.395 6	0.698（0.616，0.780）	<0.01
抗酸染色涂片+分枝杆菌分离培养	56.67	85.92	87.18	53.98	0.425 9	0.713（0.639，0.787）	<0.01
TB-DNA+TB-RNA+Gene-Xpert MTB/RIF	56.67	94.37	94.44	56.30	0.510 4	0.755（0.687，0.823）	<0.01