Application of Mycobacterium tuberculosis RNA for the Rapid Diagnosis of Lymph Node Tuberculosis Using Different Specimens

Guocan Yu; Ting Lin; Yuehui Yu; Peijun Chen; Menghan Chen; Ying Zhang; Gaoyi Yang

doi:10.2147/IDR.S392045

Application of Mycobacterium tuberculosis RNA for the Rapid Diagnosis of Lymph Node Tuberculosis Using Different Specimens

Infect Drug Resist. 2023 Jan 6:16:179-187. doi: 10.2147/IDR.S392045. eCollection 2023.

Authors

Guocan Yu¹, Ting Lin², Yuehui Yu³, Peijun Chen², Menghan Chen³, Ying Zhang^#⁴, Gaoyi Yang^#⁴

Affiliations

¹ Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
² The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
³ Division of Health Sciences, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China.
⁴ Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To evaluate the accuracy of Mycobacterium tuberculosis (MTB)-RNA in the rapid diagnosis of lymph node tuberculosis (LNTB). Moreover, the difference in the diagnostic accuracy of MTB-RNA using different specimens was determined.

Methods: We included patients with suspected LNTB who met the inclusion criteria and retrospectively analyzed their clinical data. The sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV), and area under the curve (AUC) of MTB-RNA and culture were calculated and its diagnostic accuracy for LNTB was evaluated in comparison with the final clinical diagnosis.

Results: Overall, 285 patients were included in the study. The overall sensitivity, specificity, PPV, NPV, and AUC of MTB-RNA were 40.6%, 100.0%, 100.0%, 17.0%, and 0.70, respectively. These values were 30.8%, 100.0%, 100.0%, 16.0%, and 0.65, respectively, for tissue specimens; 34.2%, 100.0%, 100.0%, 24.6%, and 0.67, respectively, for puncture specimens; and 57.14%, 100.0%, 100.0%, 5.3%, and 0.79, respectively, for pus specimens. These values of culture were 24.4%, 100.0%, 100.0%, 13.9%, and 0.62, respectively, for all specimens; 17.6%, 100.0%, 100.0%, 13.8%, and 0.59, respectively, for tissue specimens; 25.3%, 100.0%, 100.0%, 22.4%, and 0.63, respectively, for puncture specimens; and 31.0%, 100.0%, 100.0%, 3.3%, and 0.65, respectively, for pus specimens.

Conclusion: The diagnostic efficacy of MTB-RNA for the rapid diagnosis of LNTB was moderate, but its sensitivity was low. The lymph node pus specimens were the most sensitive for MTB-RNA testing, followed by puncture specimens; tissues were the least sensitive. Pus specimens should be preferably obtained in case only this test is to be used for diagnosis.

Keywords: LNTB; diagnostic accuracy; puncture; pus; sensitivity; tissue.

Grants and funding

Gaoyi Yang, 20190101A09, Hangzhou Science and Technology Bureau, http://kj.hangzhou.gov.cn. 2021KY911, 2022KY986, Health Commission of Zhejiang Province, https://wsjkw.zj.gov.cn/. The funders do not have a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.