宏基因组二代测序在肺结核诊断中的应用

Application of metagenomic next-generation sequencing in the diagnosis of pulmonary tuberculosis

目的探索宏基因组二代测序(metagenomic next-generation sequencing,mNGS)在肺结核诊断中的实际临床应用价值。方法对91例疑似肺结核患者支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)样本行mNGS、涂片、培养、Xpert比较。结果mNGS与涂片、培养的诊断敏感度存在显著性差异(P均<0.01);与Xpert之间无显著性差异(38.36%vs 41.10%,P=0.84);Xpert和mNGS联合诊断敏感度明显提高(56.16%);同时在筛查肺结核是否复发时诊断效率更高(P<0.01)。结论mNGS检测手段明显提高肺结核的诊断效能,值得推广应用。

Objective To explore the clinical application value of metagenomic next-generation sequencing(mNGS)in the diagnosis of pulmonary tuberculosis.Methods The mNGS,smear,culture and Xpert of alveolar lavage fluid samples from 91 suspected pulmonary tuberculosis patients were compared.Results The diagnostic sensitivity of mNGS was significantly different from that of smear and culture(P<0.01).There was no significant difference between Xpert and XPERT(38.36%vs 41.10%,P=0.84).The combined diagnosis sensitivity of Xpert and mNGS was significantly improved(56.16%).At the same time,the diagnostic efficiency of screening pulmonary tuberculosis recurrence was higher(P<0.01).Conclusion mNGS can improve the diagnostic efficiency of pulmonary tuberculosis,and it is worth popularizing.