评估肺结核的快速诊断检验
|
By LabMedica International staff writers Posted on 02 May 2018 |
|
图片：Xpert MTB/RIF试剂载入GeneXpert 4模块仪器（图片蒙Cepheid公司惠赐）。
在资源有限的场合诊断涂片阴性肺结核与肺外结核(TB)仍是一项挑战。确认涂片阴性与肺外结核病例需要阳性的结核分枝杆菌培养物，需要长达八周时间制备。
研究人员评估了是否能实现用商用的快速分子诊断检验日常诊断涂片阴性或肺外的结核，评估了其诊断准确度，还评估了现实场合HIV的患病率。
一组来自多国的科学家与瑞士日内瓦大学医院(www.hug-ge.ch)的科学家合作，在两年期间开展了一项前瞻性队列研究，相继纳入了疑似涂片阴性肺结核/肺外结核的所有病例。将病例分为四类：确实、很可能、可能有结核或有其它诊断结果。在马达加斯加的一家当地医院对疑似肺结核患者的痰液样本进行齐尔-尼尔森染色后直接做显微镜检。
来自肺结核患者和肺外结核患者的所有的抗酸杆菌(AFB)阴性涂片都被送到结核分枝杆菌实验室做二次涂片检查、培养，并用美国加利福尼亚州森尼韦尔市Cepheid股份有限公司(www.cepheid.com)的Xpert MTB/RIF进行筛查。生物液（脑脊液、腹膜液、胸腔积液）的标准分析（细胞学分析与生化分析），还对组织样本（淋巴结、皮肤活检样本、胸腔活检样本和滑膜活检样本）做了病理检查。对所有患者进行HIV血清检验。通过三种不同的构象快速检验证实了HIV的状态。
科学家发现，纳入研究的363名患者中，183人(50.4%)有疑似的涂片阴性肺结核，180人(49.6%)有疑似的肺外结核。用Xpert MTB/RIF检测经过证实的病例，灵敏度、特异性、阳性预测值、阴性预测值分别为82.4%、98.8%、98.3%和86.6%；如果把经过证实的病例和可能性大的病例一起算，这些值分别为65%、98.8%、98.5%和64%。肺外结核的诊断准确度略低于涂片阴性的肺结核。HIV感染的患病率为12.1%，但是几乎半数病例没有结核（其它诊断结果组）。
该研究的论文发表于2018年4月号的《国际传染病杂志》(International Journal of Infectious Diseases)。作者总结说，在资源贫乏场合实施结核的快速诊断是可行的。Xpert-MTB/RIF检测难诊人群的性能十分突出。这项研究得出的HIV患病率远高于所报的马达加斯加大众的患病率、结核患者的患病率以及结核以外病症患者的患病率。
日内瓦大学医院>>> www.hug-ge.ch
Cepheid >>> www.cepheid.com
Gold Member
Flocked Fiber Swabs
Puritan® Patented HydraFlock®
Clinical Informatics Platform
CLARION™
Chromogenic Culture System
InTray™ COLOREX™ ECC
Latest 实验室技术 News
Channels
Clinical Chemistry
view channel
Maternal Blood Biomarkers Identify Risk of Preterm and Early-Term Birth
Preterm and early-term births can lead to lasting complications because vital organs continue to mature during the final weeks of pregnancy. Babies born too soon face increased risks of breathing difficulties,... Read more
Simple Oral Swab Monitors Persistent Inflammation in Primary Ciliary Dyskinesia
Primary ciliary dyskinesia is a rare lung disease that affects about one in 7,500 to 10,000 live births worldwide. Symptoms can begin in the newborn period and progress to recurrent respiratory infections... Read more
Simple Blood-Based Cholesterol Efflux Assay Identifies High-Risk Coronary Plaque Features
Unstable coronary plaques are difficult to identify before they trigger acute cardiovascular events. Standard high-density lipoprotein (HDL) measurements do not always capture how well HDL particles function... Read more
Molecular Diagnostics
view channel
Genetic Testing Identifies High-Risk Patients with Inflammatory Bowel Disease
Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn’s disease, is a lifelong, unpredictable condition that can require advanced therapies or surgery. More than half a million people in the U.... Read more
Ancestry-Informed Genomics Advances Precision Cancer Prognosis
Predicting survival in common cancers remains imprecise despite widespread use of tumor sequencing to guide care. Outcome disparities among patient populations also persist, and the genomic drivers behind... Read more
New Blood Test Predicts Organ-Specific Disease and Mortality Years in Advance
Quantifying organ-specific aging remains a diagnostic challenge, even as age-related disorders drive morbidity and mortality worldwide. Chronological age poorly reflects the physiologic decline that predisposes... Read more
Hematology
view channel
Next-Generation Hematology Platform Streamlines High-Complexity Lab Workflows
Sysmex America (Chicago, IL, USA) has introduced the next generation XR-Series, centered on the XR-10 Automated Hematology Module for high-complexity laboratories. The platform builds on the widely used... Read more
Blood Eosinophil Count May Predict Cancer Immunotherapy Response and Toxicity
Immune checkpoint inhibitors have improved outcomes across many cancers, yet only a subset of patients derive durable benefit and biomarkers to guide treatment remain limited. Eosinophils, best known for... Read more
Immunology
view channel
Antibody Profiles Provide Clues to Long COVID Severity and Symptoms
Persistent symptoms after acute COVID-19 affect millions of people, causing fatigue, respiratory issues, and cognitive deficits that can be difficult to quantify with standard tests. Clinical teams lack... Read more
Aptamer-Based Biosensor Enables Mutation-Resilient SARS-CoV-2 Detection
Rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can undermine existing molecular diagnostics, especially when assays target small viral components. Double-antibody sandwich... Read more
Study Points to Autoimmune Pathway Behind Long COVID Symptoms
Long COVID leaves many SARS-CoV-2 survivors with persistent fatigue, cognitive issues, palpitations, and musculoskeletal pain for months or years. Estimates cited in new research suggest 4%–20% of infected... Read more
Metabolic Biomarker Distinguishes Latent from Active Tuberculosis and Tracks Treatment Response
Tuberculosis (TB) remains the world’s leading infectious killer, with 10.8 million cases and 1.25 million deaths recorded globally in 2023. Yet many infected individuals never develop active disease, underscoring... Read moreMicrobiology
view channel
Extracellular Vesicle Biomarker May Enable Noninvasive Monitoring of H. pylori
Helicobacter pylori infects an estimated 43.9% of the global population, affecting approximately 4.4 billion people worldwide. In many regions, including Africa, Eastern Europe, and Southeast Asia, prevalence... Read more
Rapid Molecular Screening Aims to Accelerate Hospital Infection Control for CPE
Drug-resistant infections remain a critical patient-safety threat in hospitals, with carbapenemase-producing Enterobacterales (CPE) among the most urgent concerns. In England, reports of acquired carbapenemase... Read more
Pathology
view channel
Stain-Free Imaging Platform Matches Standard Cancer Pathology
Histopathology underpins cancer diagnosis, but turnaround times and inter-laboratory variability can limit timely, consistent interpretation. Conventional staining relies on chemical dyes and multiple... Read more
New Companion Diagnostic Expands Precision Medicine in Prostate Cancer
Prostate cancer is a leading cancer diagnosis in men and becomes particularly aggressive when it presents as metastatic, hormone-sensitive disease. Tumors with loss of phosphatase and tensin homolog (PTEN)... Read more
Uncertainty-Aware AI Platform Supports Automated HER2 Assessment in Breast Cancer
Accurate assessment of human epidermal growth factor receptor 2 (HER2) is critical for breast cancer diagnosis and treatment selection, yet scoring variability and infrastructure requirements can complicate... Read more
Technology
view channel
AI Platform Links Biomarker Results to Cancer Clinical Trials and Guidelines
Oncology teams must manage growing volumes of genomic data, rapidly evolving clinical trial options, and frequently updated care guidelines, all within tight clinic schedules. Translating complex tumor... Read more
Agentic AI Platform Supports Genomic Decision-Making in Oncology
Oncology care teams increasingly face the challenge of managing complex molecular diagnostics, evolving treatment options, and extensive electronic health record documentation. Translating multimodal data... Read more
Industry
view channel
QIAGEN Enhances QIAcuity Platform with Gene Expression and Multiplexing Tools
QIAGEN (Venlo, Netherlands) has introduced additions to its QIAcuity dPCR ecosystem that focus on gene expression, expanded assay content, and workflow standardization for life sciences and biopharma users.... Read more
