Diagnostic value of the Xpert MTB/RIF assay combined with endobronchial ultrasonography with a guide sheath for peripheral nodular pulmonary tuberculosis.

Publication date: Sep 20, 2024

The diagnosis of peripheral isolated nodular lesions that are suspected as pulmonary tuberculosis (PTB) is challenging, which are not easily accessible via conventional bronchoscopy. This study evaluated the combined use of Xpert MTB/RIF assay and endobronchial ultrasonography with a guide sheath (EBUS-GS) for detecting MTB infection in peripheral lung bands, for early detection of PTB. The clinical data of 232 patients with suspected peripheral nodular PTB who underwent EBUS-GS between June 2020 and October 2023 were retrospectively reviewed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of acid-fast bacilli smear, culture, Xpert MTB/RIF assay, and pathological examination were calculated. To assess diagnostic accuracy, the results of the four methods were directly compared with the final clinical diagnosis. In total, 146 and 86 patients were clinically diagnosed with peripheral nodular PTB and non-PTB, respectively. The sensitivity, specificity, PPV, NPV, and AUC values of combined Xpert MTB/RIF assay and EBUS-GS were 47. 26%, 100. 0%, 100. 0%, 52. 76%, and 0. 74; those of acid-fast bacilli smear were 8. 22%, 97. 67%, 85. 71%, 38. 53%, and 0. 53; those of culture were 31. 51%, 100. 0%, 100. 0%, 46. 24%, and 0. 66; and those of pathological examination were 23. 97%, 97. 67%, 94. 59%, 43. 08%, and 0. 61, respectively. The diagnostic accuracy of the combined Xpert MTB/RIF assay and EBUS-GS was significantly better than that of other conventional tests. Hence, this novel technique can be routinely applied for diagnosing and managing peripheral nodular PTB.

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Concepts Keywords
June Adult
October Aged
Predictive Bronchoscopy
Pulmonary Endosonography
Tuberculosis Female
Humans
Lung
Male
Middle Aged
Molecular Diagnostic Techniques
Mycobacterium tuberculosis
Mycobacterium tuberculosis infection
Pulmonary tuberculosis
Retrospective Studies
Sensitivity and Specificity
Tuberculosis, Pulmonary
Xpert MTB/RIF

Semantics

Type Source Name
disease IDO assay
drug DRUGBANK Methyprylon
disease MESH pulmonary tuberculosis
disease MESH infection
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
disease MESH Infectious Diseases
drug DRUGBANK Coenzyme M
disease MESH Tuberculosis
pathway KEGG Tuberculosis
drug DRUGBANK Trestolone
disease MESH abnormalities
disease MESH tumor
disease IDO site
disease MESH complications
disease MESH bleeding
disease MESH lung diseases
disease MESH lung cancer
disease MESH coma
disease MESH pneumothorax
disease MESH tic
disease MESH diagnostic errors
disease IDO facility
disease IDO blood
disease MESH contraindications
disease MESH granuloma
disease MESH solitary lung nodules
drug DRUGBANK Water
drug DRUGBANK Sodium hydroxide
drug DRUGBANK Formaldehyde
disease MESH dehydration
drug DRUGBANK Ademetionine
disease MESH necrosis
disease IDO immunodeficiency
disease MESH organizing pneumonia
disease MESH pneumonia
disease MESH mycoplasma pneumonia
drug DRUGBANK Oxygen
drug DRUGBANK Epinephrine
disease MESH inflammation
disease MESH bacterial pneumonia
drug DRUGBANK Rifampicin
drug DRUGBANK Hexocyclium
drug DRUGBANK Saquinavir
disease MESH respiratory diseases
disease IDO bacteria
disease MESH Extrapulmonary tuberculosis
disease IDO cell
disease MESH pleural effusion
disease IDO primary infection
disease MESH scleritis
disease MESH ocular tuberculosis
disease MESH carcinoid tumor
disease MESH pulmonary inflammatory pseudotumor
disease MESH lymphadenopathy

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