应用新一代宏基因组测序技术鉴定胸腔积液的病因。

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Frontiers in Medicine Pub Date : 2025-03-19 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1525100
Zhiyun Yan, Cheng Sun, Wanna Tang, Weitao Cao, Jin Lv, Zhike Liang, Shuquan Wei, Weinong Zhong, Ziwen Zhao, Zhuxiang Zhao, Yujun Li
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引用次数: 0

摘要

背景:胸腔积液(PE)在临床实践中经常遇到,可由多种潜在条件引起。PE的准确鉴别诊断是至关重要的,因为治疗和预后严重依赖于潜在的病因。然而,诊断PE的原因仍然具有挑战性,依赖于缺乏敏感性且耗时的分枝杆菌学方法,或者需要侵入性活检的组织学检查。新一代宏基因组测序(mNGS)在传染病诊断中的应用前景广阔。尽管如此,将mNGS作为同时确定PE病因的综合诊断工具,特别是在结核病或恶性肿瘤病例中的应用研究有限。方法:探讨mNGS在结核性胸腔积液(TPE)和恶性胸腔积液(MPE)检测中的应用价值。共纳入35例PE患者,使用mNGS对其PE样本进行分析。结果:根据既定的诊断标准,最终确诊TPE 8例,MPE 10例,其中肺腺癌为最常见的病理类型(50%,5/10)。此外,7例患者被诊断为非感染性PE。然而,mNGS仅发现2例TPE和8例MPE。mNGS检测结核分枝杆菌的敏感性为25%(2/8),特异性为100%。对于肿瘤检测,mNGS的灵敏度为80%,特异性为92.6%,AUC为0.882。结论:mNGS可有效鉴别MPE与非MPE,但不适用于TPE的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application of the metagenomic next-generation sequencing technology to identify the causes of pleural effusion.

Background: Pleural effusion (PE), frequently encountered in clinical practice, can arise from a variety of underlying conditions. Accurate differential diagnosis of PE is crucial, as treatment and prognosis are heavily dependent on the underlying etiology. However, diagnosing the cause of PE remains challenging, relying on mycobacteriological methods that lack sensitivity and are time-consuming, or on histological examinations that require invasive biopsies. The recent advancements in metagenomic next-generation sequencing (mNGS) have shown promising applications in the diagnosis of infectious diseases. Despite this, there is limited research on the utility of mNGS as a comprehensive diagnostic tool for simultaneously identifying the causes of PE, particularly in cases of tuberculosis or malignancy.

Methods: This study aimed to assess the efficacy of mNGS in detecting tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE). A total of 35 patients with PE were included, and their PE samples were analyzed using mNGS.

Results: Among the participants, 8 were ultimately diagnosed with TPE, and 10 were diagnosed with MPE, with lung adenocarcinoma being the most prevalent pathological type (50%, 5/10), according to established diagnostic criteria. Additionally, 7 patients were diagnosed with non-infectious PE. However, mNGS identified only 2 cases of TPE and 8 cases of MPE. The sensitivity of mNGS for detecting Mycobacterium tuberculosis was 25% (2/8), while the specificity was 100%. For tumor detection, mNGS demonstrated a sensitivity of 80%, a specificity of 92.6%, and an AUC of 0.882.

Conclusion: mNGS is effective in distinguishing MPE from non-MPE, but is not suitable for diagnosing TPE.

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来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
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