Xiaoyu Liu, Xuan Wang, Yuejie Li, Qibin Liu, Chao Quan, Xiyong Dai
{"title":"病理亚型和抽样策略决定诊断敏感性宫颈淋巴结结核：回顾性研究。","authors":"Xiaoyu Liu, Xuan Wang, Yuejie Li, Qibin Liu, Chao Quan, Xiyong Dai","doi":"10.3389/fcimb.2025.1662518","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate how pathological types and sampling methods affect positivity rates of five diagnostic techniques in cervical lymph node tuberculosis.</p><p><strong>Methods: </strong>We retrospectively analyzed 198 surgically confirmed cervical lymph node tuberculosis patients from Wuhan Pulmonary Hospital. Cases were stratified by pathological subtypes and collection methods. The specimens were tested using acid-fast bacillus smear microscopy, mycobacterium tuberculosis culture, quantitative polymerase chain reaction for tuberculosis DNA, simultaneous amplification and testing for tuberculosis, or GeneXpert.</p><p><strong>Results: </strong>All 198 cases showed granulomatous inflammation. Liquefactive necrosis occurred in 91.92% (182/198) of cases, with caseous necrosis in 87.88% (174/198), adjacent soft-tissue necrosis in 57.07% (113/198), and suppurative inflammation in 20.20% (40/198). Solid alterations without liquefactive necrosis (coagulative necrosis/non-necrotizing lymphadenitis) comprised 8.08% (16/198). The overall etiological positivity rate was 90.40% (179/198). GeneXpert showed highest sensitivity (90.36%), followed by tuberculosis DNA (74.24%), simultaneous amplification and testing (40.22%), Mycobacterium tuberculosis culture (16.67%), and acid-fast bacillus smear (14.72%). Among 33 culture-positive cases, 32 (96.97%) were GeneXpert positive. Rifampicin resistance detected by GeneXpert was 5.62% (10/178). In specimens with caseous necrosis, soft-tissue necrosis, or liquefactive necrosis, GeneXpert positivity significantly exceeded tuberculosis DNA (all P < 0.01). Liquefactive necrosis samples showed higher positivity than solid-change specimens for all techniques except culture (all P < 0.001). Drainage specimens yielded higher tuberculosis DNA and GeneXpert positivity than surgical resection specimens. Combining surgical and drainage specimens increased culture positivity to 26.09%.</p><p><strong>Conclusion: </strong>Etiological positivity rates in cervical lymph node tuberculosis correlate with pathological features. Maximizing liquefactive necrosis sampling for the GeneXpert assay and combining different sampling techniques (such as, surgical resection, incision and drainage, needle biopsy) for etiological detection enhances diagnostic accuracy.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"15 ","pages":"1662518"},"PeriodicalIF":4.8000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454339/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pathological subtypes and sampling strategies determine diagnostic sensitivity in cervical lymph node tuberculosis: a retrospective study.\",\"authors\":\"Xiaoyu Liu, Xuan Wang, Yuejie Li, Qibin Liu, Chao Quan, Xiyong Dai\",\"doi\":\"10.3389/fcimb.2025.1662518\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate how pathological types and sampling methods affect positivity rates of five diagnostic techniques in cervical lymph node tuberculosis.</p><p><strong>Methods: </strong>We retrospectively analyzed 198 surgically confirmed cervical lymph node tuberculosis patients from Wuhan Pulmonary Hospital. Cases were stratified by pathological subtypes and collection methods. The specimens were tested using acid-fast bacillus smear microscopy, mycobacterium tuberculosis culture, quantitative polymerase chain reaction for tuberculosis DNA, simultaneous amplification and testing for tuberculosis, or GeneXpert.</p><p><strong>Results: </strong>All 198 cases showed granulomatous inflammation. Liquefactive necrosis occurred in 91.92% (182/198) of cases, with caseous necrosis in 87.88% (174/198), adjacent soft-tissue necrosis in 57.07% (113/198), and suppurative inflammation in 20.20% (40/198). Solid alterations without liquefactive necrosis (coagulative necrosis/non-necrotizing lymphadenitis) comprised 8.08% (16/198). The overall etiological positivity rate was 90.40% (179/198). GeneXpert showed highest sensitivity (90.36%), followed by tuberculosis DNA (74.24%), simultaneous amplification and testing (40.22%), Mycobacterium tuberculosis culture (16.67%), and acid-fast bacillus smear (14.72%). Among 33 culture-positive cases, 32 (96.97%) were GeneXpert positive. Rifampicin resistance detected by GeneXpert was 5.62% (10/178). In specimens with caseous necrosis, soft-tissue necrosis, or liquefactive necrosis, GeneXpert positivity significantly exceeded tuberculosis DNA (all P < 0.01). Liquefactive necrosis samples showed higher positivity than solid-change specimens for all techniques except culture (all P < 0.001). Drainage specimens yielded higher tuberculosis DNA and GeneXpert positivity than surgical resection specimens. Combining surgical and drainage specimens increased culture positivity to 26.09%.</p><p><strong>Conclusion: </strong>Etiological positivity rates in cervical lymph node tuberculosis correlate with pathological features. Maximizing liquefactive necrosis sampling for the GeneXpert assay and combining different sampling techniques (such as, surgical resection, incision and drainage, needle biopsy) for etiological detection enhances diagnostic accuracy.</p>\",\"PeriodicalId\":12458,\"journal\":{\"name\":\"Frontiers in Cellular and Infection Microbiology\",\"volume\":\"15 \",\"pages\":\"1662518\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454339/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Cellular and Infection Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fcimb.2025.1662518\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cellular and Infection Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcimb.2025.1662518","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Pathological subtypes and sampling strategies determine diagnostic sensitivity in cervical lymph node tuberculosis: a retrospective study.
Objective: To investigate how pathological types and sampling methods affect positivity rates of five diagnostic techniques in cervical lymph node tuberculosis.
Methods: We retrospectively analyzed 198 surgically confirmed cervical lymph node tuberculosis patients from Wuhan Pulmonary Hospital. Cases were stratified by pathological subtypes and collection methods. The specimens were tested using acid-fast bacillus smear microscopy, mycobacterium tuberculosis culture, quantitative polymerase chain reaction for tuberculosis DNA, simultaneous amplification and testing for tuberculosis, or GeneXpert.
Results: All 198 cases showed granulomatous inflammation. Liquefactive necrosis occurred in 91.92% (182/198) of cases, with caseous necrosis in 87.88% (174/198), adjacent soft-tissue necrosis in 57.07% (113/198), and suppurative inflammation in 20.20% (40/198). Solid alterations without liquefactive necrosis (coagulative necrosis/non-necrotizing lymphadenitis) comprised 8.08% (16/198). The overall etiological positivity rate was 90.40% (179/198). GeneXpert showed highest sensitivity (90.36%), followed by tuberculosis DNA (74.24%), simultaneous amplification and testing (40.22%), Mycobacterium tuberculosis culture (16.67%), and acid-fast bacillus smear (14.72%). Among 33 culture-positive cases, 32 (96.97%) were GeneXpert positive. Rifampicin resistance detected by GeneXpert was 5.62% (10/178). In specimens with caseous necrosis, soft-tissue necrosis, or liquefactive necrosis, GeneXpert positivity significantly exceeded tuberculosis DNA (all P < 0.01). Liquefactive necrosis samples showed higher positivity than solid-change specimens for all techniques except culture (all P < 0.001). Drainage specimens yielded higher tuberculosis DNA and GeneXpert positivity than surgical resection specimens. Combining surgical and drainage specimens increased culture positivity to 26.09%.
Conclusion: Etiological positivity rates in cervical lymph node tuberculosis correlate with pathological features. Maximizing liquefactive necrosis sampling for the GeneXpert assay and combining different sampling techniques (such as, surgical resection, incision and drainage, needle biopsy) for etiological detection enhances diagnostic accuracy.
期刊介绍：
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported 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.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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