Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods

The highly infectious nature of tuberculosis (TB) urges the need to increase the efficiency and rapidity of lab methods. The coexistence of TB and cancer was investigated using Mycobacterium tuberculosis direct test (MTD) and the mycobacteria growth indicator tube (MGIT), besides the conventional la...

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Main Authors: Hadir A. El-Mahallawy, Somia A. Eissa, Nefissa G. Rafeh, Ayman E.S. Salem, Soheir A. Eissa, Soheir A. Allian
Format: Article
Language:English
Published: Elsevier 2010-04-01
Series:Journal of Advanced Research
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2090123210000391
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author Hadir A. El-Mahallawy
Somia A. Eissa
Nefissa G. Rafeh
Ayman E.S. Salem
Soheir A. Eissa
Soheir A. Allian
author_facet Hadir A. El-Mahallawy
Somia A. Eissa
Nefissa G. Rafeh
Ayman E.S. Salem
Soheir A. Eissa
Soheir A. Allian
author_sort Hadir A. El-Mahallawy
collection DOAJ
description The highly infectious nature of tuberculosis (TB) urges the need to increase the efficiency and rapidity of lab methods. The coexistence of TB and cancer was investigated using Mycobacterium tuberculosis direct test (MTD) and the mycobacteria growth indicator tube (MGIT), besides the conventional lab procedures. All assays were performed on 101 patients clinically suspected of having a mycobacterial infection. Over a period of 4 years, TB was confirmed in 32 patients with malignancy by applying the gold standard of considering patients with positive culture on Lowenstein–Jensen or MGIT or having any two or more positive tests as confirmed mycobacterial infection. Among the confirmed cases, the underlying malignant conditions were hematologic malignancies, bronchogenic carcinoma, and other solid tumors, in 14, 12, and 6 of the patients; respectively. TB developed during cancer chemotherapy in 18 cases (56%), and was discovered synchronously with malignancy in 14 (44%) patients. The ZN stain revealed acid-fast bacilli in 15 (47%) cases. The LJ culture was positive in 20 (63%) cases and MGIT was positive in 18 (56%) cases. Although the MTD test was positive in 18 (56%) of the confirmed TB cases; i.e., it was negative in 14 cases positive by other tests. There was a moderate agreement between results of LJ and MGIT, Kappa 0.396 and ZN and MGIT, Kappa 0.436. There was a weak agreement between results of LJ and MTD, ZN and MTD, Kappa 0.227 and 0.209; respectively; whereas, no agreement was calculated between MGIT and MTD Kappa 0.029. The calculation of the combined sensitivity of any two tests was 94%. TB is a major pathogen in patients with malignant diseases if clinically suspected. Little overlap between different technologies used necessitates the utilization of combination of tests together with consideration of key clinical characteristics to improve the diagnostic accuracy of TB.
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spelling doaj.art-810466ee0f2a49c19155d7a9f06bb9b02022-12-21T21:03:37ZengElsevierJournal of Advanced Research2090-12322090-12242010-04-011215716210.1016/j.jare.2010.03.008Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methodsHadir A. El-Mahallawy0Somia A. Eissa1Nefissa G. Rafeh2Ayman E.S. Salem3Soheir A. Eissa4Soheir A. Allian5Department of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, EgyptDepartment of Microbiology and Immunology, Faculty of Medicine, Cairo University, EgyptDepartment of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, EgyptChest Department, Faculty of Medicine, Cairo University, EgyptDepartment of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, EgyptDepartment of Microbiology and Immunology, Faculty of Medicine, Cairo University, EgyptThe highly infectious nature of tuberculosis (TB) urges the need to increase the efficiency and rapidity of lab methods. The coexistence of TB and cancer was investigated using Mycobacterium tuberculosis direct test (MTD) and the mycobacteria growth indicator tube (MGIT), besides the conventional lab procedures. All assays were performed on 101 patients clinically suspected of having a mycobacterial infection. Over a period of 4 years, TB was confirmed in 32 patients with malignancy by applying the gold standard of considering patients with positive culture on Lowenstein–Jensen or MGIT or having any two or more positive tests as confirmed mycobacterial infection. Among the confirmed cases, the underlying malignant conditions were hematologic malignancies, bronchogenic carcinoma, and other solid tumors, in 14, 12, and 6 of the patients; respectively. TB developed during cancer chemotherapy in 18 cases (56%), and was discovered synchronously with malignancy in 14 (44%) patients. The ZN stain revealed acid-fast bacilli in 15 (47%) cases. The LJ culture was positive in 20 (63%) cases and MGIT was positive in 18 (56%) cases. Although the MTD test was positive in 18 (56%) of the confirmed TB cases; i.e., it was negative in 14 cases positive by other tests. There was a moderate agreement between results of LJ and MGIT, Kappa 0.396 and ZN and MGIT, Kappa 0.436. There was a weak agreement between results of LJ and MTD, ZN and MTD, Kappa 0.227 and 0.209; respectively; whereas, no agreement was calculated between MGIT and MTD Kappa 0.029. The calculation of the combined sensitivity of any two tests was 94%. TB is a major pathogen in patients with malignant diseases if clinically suspected. Little overlap between different technologies used necessitates the utilization of combination of tests together with consideration of key clinical characteristics to improve the diagnostic accuracy of TB.http://www.sciencedirect.com/science/article/pii/S2090123210000391TuberculosisMycobacterium tuberculosis direct test (MTD)Mycobacteria growth indicator tube (MGIT)TB infectionsCancer patients
spellingShingle Hadir A. El-Mahallawy
Somia A. Eissa
Nefissa G. Rafeh
Ayman E.S. Salem
Soheir A. Eissa
Soheir A. Allian
Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
Journal of Advanced Research
Tuberculosis
Mycobacterium tuberculosis direct test (MTD)
Mycobacteria growth indicator tube (MGIT)
TB infections
Cancer patients
title Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
title_full Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
title_fullStr Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
title_full_unstemmed Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
title_short Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods
title_sort tuberculosis in cancer patients role of newer techniques in relation to conventional diagnostic methods
topic Tuberculosis
Mycobacterium tuberculosis direct test (MTD)
Mycobacteria growth indicator tube (MGIT)
TB infections
Cancer patients
url http://www.sciencedirect.com/science/article/pii/S2090123210000391
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AT aymanessalem tuberculosisincancerpatientsroleofnewertechniquesinrelationtoconventionaldiagnosticmethods
AT soheiraeissa tuberculosisincancerpatientsroleofnewertechniquesinrelationtoconventionaldiagnosticmethods
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