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对抗结核病的新工具:环介导等温扩增-侧向流动分析法在资源有限环境中的潜力

New Tool Against Tuberculosis: The Potential of the LAMP Lateral Flow Assay in Resource-Limited Settings.

作者信息

Rosas-Diaz Marisol, Palacios-Reyes Carmen, Godinez-Aguilar Ricardo, Escalante-Bautista Deyanira, Alfaro Hernández Laura, Juarez-Islas Ana P, Segundo-Ibañez Patricia, Salas-Cuevas Gabriela, Olvera-Serrano Ángel, Hernandez-Martinez Juan Carlos, Ramos-Garcia Victor Hugo, Garcia Oropesa Esperanza Milagros, Flores-García Omar, Galvez-Romero Jose Luis, León Burgoa Griselda, Nolasco-Quiroga Manuel

机构信息

Molecular Biology Laboratory, Multidisciplinary Academic Unit Reynosa-Aztlan Reynosa, Autonomous University of Tamaulipas, Ciudad Victoria 88740, Tamaulipas, Mexico.

Department of Medical Sciences, Division of Health Sciences, University of Guanajuato, Campus Leon, León de los Aldama 37000, Guanajuato, Mexico.

出版信息

Curr Issues Mol Biol. 2025 Jul 23;47(8):585. doi: 10.3390/cimb47080585.

Abstract

Tuberculosis (TB) is a global public health issue requiring early and accurate diagnosis. The loop-mediated isothermal amplification (LAMP) assay is a promising alternative recommended by the WHO for the initial diagnosis of pulmonary TB, particularly in resource-limited settings. This study evaluated the sensitivity and specificity of a commercial LAMP assay for TB detection using 198 samples from different countries including Mexico. The LAMP assay results were compared to the results of standard tests: AFB smear microscopy, cell culture, and Xpert PCR. Across all samples, LAMP showed a sensitivity of 96.20% and a specificity of 84.61%. When compared specifically to "true positives" and "true negatives" (defined by the consistency across the standard tests), LAMP demonstrated 100% sensitivity and 92.30% specificity. For context, the sensitivity of AFB smear microscopy against the culture and Xpert tests was 79.04%. A significant finding was that the LAMP test detected a high percentage (92.5%) of samples found positive by the culture and Xpert tests but negative by the AFB smear, highlighting its ability to identify cases missed by traditional microscopy. This study concluded that the LAMP assay is a sensitive and specific tool for TB diagnosis with potential for rapid and accurate diagnosis, especially in resource-limited areas.

摘要

结核病是一个全球性的公共卫生问题,需要早期准确诊断。环介导等温扩增(LAMP)检测法是世界卫生组织推荐的一种有前景的替代方法,用于肺结核的初步诊断,尤其是在资源有限的环境中。本研究使用来自包括墨西哥在内的不同国家的198份样本,评估了一种用于结核病检测的商业LAMP检测法的敏感性和特异性。将LAMP检测结果与标准检测结果进行比较:抗酸杆菌涂片显微镜检查、细胞培养和Xpert PCR。在所有样本中,LAMP的敏感性为96.20%,特异性为84.61%。当与“真阳性”和“真阴性”(由标准检测的一致性定义)进行具体比较时,LAMP的敏感性为100%,特异性为92.30%。相比之下,抗酸杆菌涂片显微镜检查相对于培养和Xpert检测的敏感性为79.04%。一个重要发现是,LAMP检测法检测出了很大比例(92.5%)经培养和Xpert检测呈阳性但抗酸杆菌涂片呈阴性的样本,突出了其识别传统显微镜检查漏诊病例的能力。本研究得出结论,LAMP检测法是一种用于结核病诊断的敏感且特异的工具,具有快速准确诊断的潜力,尤其是在资源有限的地区。

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本文引用的文献

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Low-complexity manual nucleic acid amplification tests for pulmonary tuberculosis in children.
Cochrane Database Syst Rev. 2025 Jun 25;6(6):CD015806. doi: 10.1002/14651858.CD015806.pub2.
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