Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study
ObjectiveTo compare the diagnostic performance of laboratory assays on the ultrasound-guided core needle biopsy samples for diagnosis of extra-pulmonary tuberculosis (EPTB) in HIV-positive and HIV-negative patients.MethodsA total of 217 patients suspected to have EPTB underwent lesion biopsy from 20...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1154939/full |
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| author | Jin-Chuan Xu Xia Shi Xin Ma Wen-fei Gu Wen-fei Gu Zhi-xiong Fang Hui Zhang Xiao-Yong Fan Xiao-Yong Fan |
| author_facet | Jin-Chuan Xu Xia Shi Xin Ma Wen-fei Gu Wen-fei Gu Zhi-xiong Fang Hui Zhang Xiao-Yong Fan Xiao-Yong Fan |
| author_sort | Jin-Chuan Xu |
| collection | DOAJ |
| description | ObjectiveTo compare the diagnostic performance of laboratory assays on the ultrasound-guided core needle biopsy samples for diagnosis of extra-pulmonary tuberculosis (EPTB) in HIV-positive and HIV-negative patients.MethodsA total of 217 patients suspected to have EPTB underwent lesion biopsy from 2017 to 2020. Results of laboratory tests on the biopsy and non-biopsy samples were collected with clinical data for retrospective analysis of test utility. The calculated diagnostic accuracy of the tests was stratified according to the specimen types and HIV status.ResultsThe cohort contained 118 patients with a final positive diagnosis of extrapulmonary tuberculosis (EPTB group, 54.4%) and 99 finally diagnosed as without TB (non-EPTB group, 45.6%). The risk factor for EPTB was HIV co-infection (OR 2.22, 95% CI 1.17-4.28, p = 0.014). In biopsy samples, GeneXpert (Xpert) showed higher sensitivity (96.6% [91.6-98.7], p < 0.0001) than culture (56.1% [47.0-64.9]). Regardless of HIV status, Xpert had the highest sensitivity (>95%) and specificity (nearly 100%) of any methods. In non-biopsy samples, only T-SPOT.TB (T-SPOT) showed higher sensitivity than culture (90.9% [62.3-99.5] vs 35.3% [17.3-58.7], p = 0.0037). Furthermore, the sensitivities of Xpert were lower in non-biopsy samples (60.0% [23.1-92.9], p = 0.022) than in biopsy samples (100% [86.7-100]). Even in smear-negative biopsy samples, Xpert still had higher sensitivity than culture and retained high specificity (100% [95.7-100]).ConclusionSuperior performance of Xpert in diagnosing EPTB was observed regardless of HIV status and specimen types. Nevertheless, the biopsy samples still substantially facilitated the accurate diagnosis of extrapulmonary tuberculosis. |
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| format | Article |
| id | doaj.art-3591cd3871f94607bae3614e7dbd54c0 |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-04-09T22:21:29Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-3591cd3871f94607bae3614e7dbd54c02023-03-22T15:40:06ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882023-03-011310.3389/fcimb.2023.11549391154939Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison studyJin-Chuan Xu0Xia Shi1Xin Ma2Wen-fei Gu3Wen-fei Gu4Zhi-xiong Fang5Hui Zhang6Xiao-Yong Fan7Xiao-Yong Fan8Shanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaShanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaShanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaShanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaSchool of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, ChinaDepartment of Infectious Diseases and Public Health, Central Hospital of Xiangtan, Xiangtan, ChinaShanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaShanghai Public Health Clinical Center, Fudan University, Shanghai, ChinaSchool of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, ChinaObjectiveTo compare the diagnostic performance of laboratory assays on the ultrasound-guided core needle biopsy samples for diagnosis of extra-pulmonary tuberculosis (EPTB) in HIV-positive and HIV-negative patients.MethodsA total of 217 patients suspected to have EPTB underwent lesion biopsy from 2017 to 2020. Results of laboratory tests on the biopsy and non-biopsy samples were collected with clinical data for retrospective analysis of test utility. The calculated diagnostic accuracy of the tests was stratified according to the specimen types and HIV status.ResultsThe cohort contained 118 patients with a final positive diagnosis of extrapulmonary tuberculosis (EPTB group, 54.4%) and 99 finally diagnosed as without TB (non-EPTB group, 45.6%). The risk factor for EPTB was HIV co-infection (OR 2.22, 95% CI 1.17-4.28, p = 0.014). In biopsy samples, GeneXpert (Xpert) showed higher sensitivity (96.6% [91.6-98.7], p < 0.0001) than culture (56.1% [47.0-64.9]). Regardless of HIV status, Xpert had the highest sensitivity (>95%) and specificity (nearly 100%) of any methods. In non-biopsy samples, only T-SPOT.TB (T-SPOT) showed higher sensitivity than culture (90.9% [62.3-99.5] vs 35.3% [17.3-58.7], p = 0.0037). Furthermore, the sensitivities of Xpert were lower in non-biopsy samples (60.0% [23.1-92.9], p = 0.022) than in biopsy samples (100% [86.7-100]). Even in smear-negative biopsy samples, Xpert still had higher sensitivity than culture and retained high specificity (100% [95.7-100]).ConclusionSuperior performance of Xpert in diagnosing EPTB was observed regardless of HIV status and specimen types. Nevertheless, the biopsy samples still substantially facilitated the accurate diagnosis of extrapulmonary tuberculosis.https://www.frontiersin.org/articles/10.3389/fcimb.2023.1154939/fullextrapulmonary tuberculosis (EPTB)diagnosisbiopsyXperthuman immunodeficiency virus (HIV) |
| spellingShingle | Jin-Chuan Xu Xia Shi Xin Ma Wen-fei Gu Wen-fei Gu Zhi-xiong Fang Hui Zhang Xiao-Yong Fan Xiao-Yong Fan Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study Frontiers in Cellular and Infection Microbiology extrapulmonary tuberculosis (EPTB) diagnosis biopsy Xpert human immunodeficiency virus (HIV) |
| title | Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study |
| title_full | Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study |
| title_fullStr | Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study |
| title_full_unstemmed | Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study |
| title_short | Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study |
| title_sort | diagnosis of extrapulmonary tuberculosis by ultrasound guided biopsy a retrospective comparison study |
| topic | extrapulmonary tuberculosis (EPTB) diagnosis biopsy Xpert human immunodeficiency virus (HIV) |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1154939/full |
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