The value of histopathologic examination and Xpert (MTB/RIF) assay in diagnosis of cervical lymph node tuberculosis after coarse needle biopsy guided by CEUS: a retrospective analysis of 612 cases.

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

European Journal of Clinical Microbiology & Infectious Diseases Pub Date : 2024-10-01 Epub Date: 2024-08-01 DOI:10.1007/s10096-024-04913-9

Wenzhi Zhang, Jianping Xu, Lin Zhang, Tu Ni

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Abstract

Objective: To investigate the value of histopathological examination (HPE) and Xpert Mycobacterium tuberculosis bacilli/rifampicin (MTB/RIF) assay in diagnosis of cervical lymph node tuberculosis (LN TB) after coarse needle biopsy (CNB).

Methods: We retrospectively analyzed 612 samples obtained from October 2017 to August 2023 from patients suspected cervical LN TB with surgically pathological, microbial culture confirmed, and clinically confirmed cervical lymph node enlargement who received ultrasound-guided CNB assisted by contrast-enhanced ultrasound (CEUS) at our hospital. All specimens were assessed by HPE and the Xpert (MTB/RIF) assay. We analyzed the results to determine the diagnostic value of HPE and Xpert (MTB/RIF) assay in samples taken after CEUS-assisted CNB of LN TB, and to evaluate the safety of CNB.

Results: Based on the comprehensive reference standard established in this study, 532 of 612 patients were diagnosed with cervical LN TB, of which 476 were CNB positive cases, the positive rate of diagnosis was 89.5%。The sensitivity, specificity, positive predictive value, negative and predictive value of HPE were 80.4%, 91.2%, 98.4%, 41.2% respectively, while those of the Xpert MTB/RIF assay were 75.7%, 98.7%, 99.7%, 38.0% respectively. No postoperative complications were noted, and the Clavien-Dindo grade was 2.

Conclusion: CEUS-assisted CNB has high diagnostic value and is safe for cervical LN TB. The sensitivity of HPE is slightly higher than that of Xpert (MTB/RIF) assay, and the specificity of Xpert (MTB/RIF) assay is higher than that of HPE, so Xpert (MTB/RIF) assay can correct the cervical lymph node tuberculosis with negative HPE.

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在 CEUS 引导下进行粗针活检后，组织病理学检查和 Xpert (MTB/RIF) 检测对宫颈淋巴结结核诊断的价值：对 612 例病例的回顾性分析。

目的探讨组织病理学检查（HPE）和Xpert结核分枝杆菌/利福平（MTB/RIF）检测在粗针活检（CNB）后宫颈淋巴结结核（LN TB）诊断中的价值：我们回顾性分析了2017年10月至2023年8月期间获得的612份样本，这些样本来自我院接受超声引导CNB辅助造影剂增强超声（CEUS）检查的疑似宫颈淋巴结结核患者，这些患者均经手术病理、微生物培养证实和临床证实为宫颈淋巴结肿大。所有标本均通过 HPE 和 Xpert（MTB/RIF）检测进行评估。我们对结果进行了分析，以确定 HPE 和 Xpert（MTB/RIF）检测在 CEUS 辅助下行 LN 结核病 CNB 后样本中的诊断价值，并评估 CNB 的安全性：根据该研究建立的综合参考标准，612 例患者中有 532 例确诊为宫颈 LN TB，其中 476 例为 CNB 阳性病例，确诊阳性率为 89.5%。HPE 的灵敏度、特异性、阳性预测值、阴性预测值和预测值分别为 80.4%、91.2%、98.4%、41.2%，而 Xpert MTB/RIF 检测的灵敏度、特异性、阳性预测值、阴性预测值和预测值分别为 75.7%、98.7%、99.7%、38.0%。术后未发现并发症，Clavien-Dindo分级为2.Conclusion：结论：CEUS辅助CNB对宫颈LN结核的诊断价值高且安全。HPE 的灵敏度略高于 Xpert（MTB/RIF）测定，而 Xpert（MTB/RIF）测定的特异性高于 HPE，因此 Xpert（MTB/RIF）测定可以纠正 HPE 阴性的宫颈淋巴结结核。

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来源期刊

European Journal of Clinical Microbiology & Infectious Diseases 医学-传染病学

CiteScore

10.40

自引率

2.20%

发文量

138

审稿时长

1 months

期刊介绍： EJCMID is an interdisciplinary journal devoted to the publication of communications on infectious diseases of bacterial, viral and parasitic origin.