The Role of Core Needle Biopsy Pathology Combined with Molecular Tests in the Diagnosis of Lymph Node Tuberculosis.
The Role of Core Needle Biopsy Pathology Combined with Molecular Tests in the Diagnosis of Lymph Node Tuberculosis.
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DOI：
10.2147/idr.s350570
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发表时间：
2022
影响因子：
3.9
通讯作者：
Zhou L
中科院分区：
文献类型：
--
作者：
Shen Y;Fang L;Ye B;Xu X;Yu G;Zhou L
淋巴结结核的早期诊断仍然很困难。大多数LN标本需要进行侵入性和不愉快的程序。评价病理学结合分子检测诊断空芯针活检（CNB）标本中LNTB的诊断效力，并将该诊断效力与单独组织标本检查的诊断效力进行比较。我们回顾性分析了符合纳入标准的LNTB患者的病历。计算病理学、分子学检测和平行检测（这两种检测中任一种检测的阳性结果）的灵敏度、特异性、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC），以评价其与复合参考标准相比的诊断效力。共有289名患者被纳入研究。病理学、分子学和平行试验的总体敏感性、特异性、PPV、NPV和AUC分别为94.5%、97.2%、99.6%、71.4%、0.96; 73.1%、100.0%、100.0%、34.6%、0.87; 98.4%、97.2%、99.6%、89.7%、0.98。对CNB标本，病理学、分子学和平行试验的上述值分别为93.3%、96.2%、99.4%、69.4%、0.95; 76.4%、100.0%、100.0%、40.0%、0.88; 99.4%、96.2%、99.4%、96.2%、0.98;而组织中相应值分别为96.6%、100.0%、100.0%、76.9%、0.98;分别为67.1%、100.0%、100.0%、25.6%、0.84和96.6%、100.0%、100.0%、76.9%、0.98。使用CNB标本进行病理学和分子学检测的有效性与相关评估方法的组织标本相似。对于LNTB的诊断，CNB标本是首选的同时进行病理检查和分子检测。
Early lymph node tuberculosis (LNTB) diagnosis is still difficult. The majority of LN specimens require the undertaking of invasive and unpleasant procedures. To evaluate the diagnostic efficacy of pathology when combined with molecular tests for the diagnosis of LNTB in core needle biopsy (CNB) specimens and to compare that diagnostic efficacy with that deriving from tissue specimens’ examination alone. We retrospectively analyzed the medical records of LNTB patients who met the inclusion criteria. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of pathology, molecular tests, and parallel test (positive result for either of these two assays) were calculated to evaluate their diagnostic efficacy compared with a composite reference standard. A total of 289 patients were included in the study. The overall sensitivity, specificity, PPV, NPV, and AUC of pathology, molecular tests, and parallel test were 94.5%, 97.2%, 99.6%, 71.4%, 0.96; 73.1%, 100.0%, 100.0%, 34.6%, 0.87; and 98.4%, 97.2%, 99.6%, 89.7%, 0.98, respectively. For CNB specimens, these values for pathology, molecular tests, and parallel test were 93.3%, 96.2%, 99.4%, 69.4%, 0.95; 76.4%, 100.0%, 100.0%, 40.0%, 0.88; and 99.4%, 96.2%, 99.4%,96.2%,0.98, while those same values for the tissue were 96.6%, 100.0%, 100.0%, 76.9%, 0.98; 67.1%, 100.0%, 100.0%, 25.6%, 0.84; and 96.6%, 100.0%, 100.0%, 76.9%,0.98, respectively. The validity of pathology and molecular testing when using CNB specimens was similar to that of tissue specimens for relevant assessment approaches. For the LNTB diagnosis, CNB specimens were preferred for the simultaneous undertaking of pathological examination and molecular testing.