JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)

• Original article (Clinical research) • Previous Articles     Next Articles

Diagnostic value of Xpert MTB/RIF in lymph node tuberculo

KE Hui, GUI Xu-wei, GU Jin   

  1. Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
  • Received:2021-05-31 Published:2021-09-23
  • Contact: GU Jin, E-mail: gujin51250@163.com.
  • Supported by:
    Shanghai Clinical Research Center for infectious disease (tuberculosis) (19MC1910800).

Abstract: Objective·To analyze the significance of the combination of rifampicin-resistant Mycobacterium tuberculosis semi-nested multiple real-time fluorescence quantitative system(Xpert MTB/RIF) detection in improving the diagnostic rate of lymph node tuberculosis. Methods·Retrospective analysis was performed on the clinical data of 351 patients who were initially diagnosed with cervical lymph node tuberculosis and received lymph node puncture in Shanghai Pulmonary Hospital from January 2016 to December 2018. The lymph node puncture materials were sent for tuberculosis smear,tuberculosis culture, tuberculosis DNA test, pathology test and Xpert MTB/RIF test. The positive rates of different detection methods and tuberculosis smear, tuberculosis culture, tuberculosis DNA test and pathological test combined with Xpert MTB/RIF test were analyzed. Results·A total of 145 patients with confirmed lymph node tuberculosis were included. Among them, 39 patients were tuberculosis smear positive, 74 patients were tuberculosis DNA positive, 111 patients were Xpert MTB/RIF positive, 51 patients were tuberculosis culture positive, and 87 patients were pathologically positive.Xpert MTB/RIF detected 8 patients with rifampicin drug resistance, of which 6 patients were negative in tuberculosis culture, and 2 patients were rifampicin drug resistant in tuberculosis culture. The positive rate of tuberculosis DNA combined with Xpert MTB/RIF was the highest(91.0%), which was significantly higher than that of tuberculosis smear combined with Xpert MTB/RIF(80.7%), and the difference was statistically significant(P=0.017). It was also higher than that of tuberculosis culture combined with Xpert MTB/RIF test(88.3%) and pathology combined with Xpert MTB/RIF test(90.3%), but there was no statistical significance(all P>0.05). Conclusion·The combination of Xpert MTB/RIF could improve the early diagnosis rate of lymph node tuberculosis.

Key words: rifampicin-resistant Mycobacterium tuberculosis semi-nested multiple real-time fluorescence quantitative system(Xpert MTB/RIF), lymph node tuberculosis, diagnosis, drug resistance

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