宏基因组下一代测序在非结核分枝杆菌肺病中的临床应用的诊断性能。
Diagnostic performance of metagenomic next-generation sequencing in non-tuberculous mycobacterial pulmonary disease when applied to clinical practice.
机构信息
Shanghai Clinical Research Center for Infectious Disease (Tuberculosis), Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
出版信息
Infection. 2023 Apr;51(2):397-405. doi: 10.1007/s15010-022-01890-z. Epub 2022 Aug 1.
OBJECTIVE
To compare non-tuberculous mycobacterial pulmonary disease (NTMPD) diagnosis by metagenomic next-generation sequencing (mNGS) with Bactec mycobacterial growth indicator tube (MGIT) 960.
METHODS
A total of 422 patients with suspected NTMPD in Shanghai Pulmonary Hospital between January 2020 and May 2021 were retrospectively analyzed; 194 were diagnosed with NTMPD. The diagnostic performance of mNGS and MGIT 960 for NTMPD was assessed. Receiver operating characteristic (ROC) curves and areas under curve (AUCs) were compared.
RESULTS
The sensitivity of mNGS in NTMPD diagnosis was 81.4% and higher than that of MGIT 960 (53.6%). The specificity of mNGS in NTMPD diagnosis was 97.8%, similar to that of MGIT 960 (100%). The sensitivity of combined mNGS and MGIT 960 in NTMPD diagnosis was 91.8%. The sensitivity of mNGS for bronchoalveolar lavage fluid (BALF), pulmonary puncture tissue fluid, and sputum was 84.8%, 80.6%, and 77.5%, respectively; all were higher than that of MGIT 960 (P < 0.05). The AUC of mNGS and MGIT 960 was 0.897 and 0.768, respectively. The AUC of mNGS were BALF (0.916), pulmonary puncture tissue fluid (0.903), and sputum (0.870).
CONCLUSION
The sensitivity of mNGS was superior to that of Bactec MGIT 960; the specificity in NTMPD diagnosis was similar. mNGS shows effective performance in NTMPD diagnosis.
目的
比较宏基因组下一代测序（mNGS）与 Bactec 分枝杆菌液体培养检测系统（MGIT）960 对非结核分枝杆菌肺病（NTMPD）的诊断价值。
方法
回顾性分析 2020 年 1 月至 2021 年 5 月上海肺科医院 422 例疑似 NTMPD 患者，194 例患者诊断为 NTMPD。评估 mNGS 和 MGIT 960 对 NTMPD 的诊断性能。比较受试者工作特征（ROC）曲线和曲线下面积（AUC）。
结果
mNGS 诊断 NTMPD 的敏感度为 81.4%，高于 MGIT 960（53.6%）。mNGS 诊断 NTMPD 的特异度为 97.8%，与 MGIT 960（100%）相当。mNGS 联合 MGIT 960 诊断 NTMPD 的敏感度为 91.8%。mNGS 对支气管肺泡灌洗液（BALF）、经皮肺穿刺组织液和痰液的敏感度分别为 84.8%、80.6%和 77.5%，均高于 MGIT 960（P < 0.05）。mNGS 和 MGIT 960 的 AUC 分别为 0.897 和 0.768。mNGS 的 BALF（0.916）、经皮肺穿刺组织液（0.903）和痰液（0.870）的 AUC 均大于 MGIT 960。
结论
mNGS 的敏感度优于 Bactec MGIT 960，对 NTMPD 的诊断特异性相当。mNGS 对 NTMPD 具有较好的诊断效能。
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