摘要
目的评价支气管镜检查及肺泡灌洗液二代基因测序对HIV阳性肺结核的诊断价值。方法收集2019年1月至2022年1月石家庄市第五医院的30例HIV阳性临床疑似肺结核或具有肺结核相关体征/症状且行支气管镜检查者的病例资料(其中24例送检肺泡灌洗液NGS)。分析其支气管镜下表现;利用ROC曲线评价肺泡灌洗液NGS及Xpert对HIV阳性肺结核的诊断价值;利用ROC曲线评价痰液、支气管镜及支气管镜联合痰液对HIV阳性肺结核的诊断价值。结果支气管镜检查结果:淋巴结瘘3例,新生物10例,瘢痕、狭窄3例,支气管炎性改变9例,未见异常5例;BALF NGS和Xpert诊断HIV阳性肺结核敏感度分别为71%、47%,特异度均为100%,ROC曲线下的面积值为0.85、0.74;痰液、支气管镜、痰液联合支气管镜诊断HIV阳性肺结核的敏感度分别为41%、68%、86%,特异度分别为88%、100%、88%,ROC曲线下的面积值为0.64、0.84、0.87。结论支气管镜检查及肺泡灌洗液二代基因测序是诊断HIV阳性肺结核的重要工具。
Objectives To evaluate the diagnostic performance of bronchoscopy and next⁃genera⁃tion gene sequencing of alveolar lavage fluid in patients with HIV positive tuberculosis.Methods The case data of 30 HIV⁃positive patients with suspected pulmonary tuberculosis or those with tuberculosis⁃related signs/symptoms who underwent bronchoscopy from January 2019 to January 2022 in Shijiazhuang Fifth Hospital were collected(24 of them were sent for bronchoalveolar lavage fluid NGS).Analyzed their bronchoscopic performance;ROC curves were used to evaluate the diagnostic value of alveolar lavage fluid NGS and Xpert for HIV positive tuberculosis;ROC curves were used to evaluate the diagnostic value of sputum,combined bronchoscopy and combined bronchoscopy for HIV positive tuberculosis.Results Bronchoscopy results:lymph node fistula 3 cases,new organism 10 cases,scar and stenosis 3 cases,bronchial inflammatory chang⁃es 9 cases,no abnormalities 5 cases;The sensitivity of BALF NGS and Xpert in diagnosing HIV positive pul⁃monary tuberculosis was 71%,47%,the specificity was both 100%,and the area under the ROC curve values were 0.85,0.74;The pooled sensitivity and specificity of sputum and combined modality bronchoscopy for the diagnosis of HIV positive TB were 41%,68%,and 86%,respectively,and the values of the area under the ROC curve were 0.64,0.84,and 0.87,respectively.Conclusions Bronchoscopy and Next⁃generation gene sequencing of alveolar lavage fluid are important tools in the diagnosis of HIV positive tuberculosis。
作者
刘士甫
张鑫
佘丽君
戴二黑
赵磊
王海宾
王立静
LIU Shifu;ZHANG Xin;SHE Lijun;DAI Erhei;ZHAO Lei;WANG Haibin;WANG Lijing(Department of Tuberculosis,Shijiazhuang Fifth Hospital,The clinical training base for the prevention and treatment of multidrug-resistant tuberculosis,Shijiazhuang,Hebei,China,050000;Department of Labora-tory Medicine,Shijiazhuang,China,050000;Department of AIDS.The Fifth Hospital of Shijiazhuang,Shijiazhuang,Hebei,China,050000)
出处
《分子诊断与治疗杂志》
2023年第6期1082-1085,1090,共5页
Journal of Molecular Diagnostics and Therapy
基金
河北省科技成果重点推广计划(20220204)。
关键词
支气管镜
肺泡灌洗液
二代基因测序
HIV阳性肺结核
诊断价值
Bronchoscopy
Alveolar lavage fluid
Next generation sequencing
HIV positive tu⁃berculosis
Diagnostic value
