关键词: 结核,肺, 支气管肺泡灌洗液, 痰, 胸腔积液, 诊断技术和方法, 组织细胞学制备技术, 对比研究

Abstract:

Objective To explore application value of Thinprep cytologic test (TCT) in the diagnosis of pulmonary tuberculosis.Methods According to inclusion criteria,248 suspected tuberculosis patients from Zhangjiakou Infectious Disease Hospital between November 2017 and February 2019 were selected, and based on confirmed diagnosis,181 were pulmonary tuberculosis, while the other 67 were not. A total of 248 samples including sputum (n=101), pleural effusion (n=67) and bronchoalveolar lavage fluid (n=80), from the 248 patients one each according to their clinical features and symptoms, were tested with TCT, Z-N staining and MGIT 960, to detect mycobacterium. Data were analyzed by χ ² test using SPSS 19.0, P<0.05 was considered statistically significant. Results The positive rates of all 248 samples (53.63% (133/248) vs. 25.81% (64/248), χ ²=46.788, P=0.000), sputum (67.33% (68/101) vs. 36.63% (37/101), χ ²=19.736, P=0.000), pleural effusion (17.91% (12/67) vs. 7.46% (5/67), χ ²=9.449, P=0.002) and bronchoalveolar lavage fluid (66.25% (53/80) vs. 27.50% (22/80), χ ²=20.833, P=0.000) using TCT were significantly higher than those using Z-N staining. The positive rate of sputum using TCT was significantly lower than using MGIT 960 (67.32% (68/101) vs. 81.19% (82/101), χ ²=5.076, P=0.024), while the difference of the positive rates of pleural effusion (17.91% (12/67) vs. 25.37% (17/67), χ ²=1.100, P=0.294) and bronchoalveolar lavage fluid (66.25% (53/80) vs. 70.00% (56/8), χ ²=0.377, P=0.539) between the two methods were not statistically significant. Based on clinical diagnosis, sensitivities of TCT, Z-N staining and MGIT 960 in testing all the samples were 72.93% (132/181), 30.39% (55/181) and 85.64% (155/181), respectively; the consistency rates of the three methods were 79.84% (198/248), 48.79% (121/248) and 89.52% (222/248), respectively; the specificities were 98.51% (66/67), 98.51% (66/67) and 100.00% (67/67), respectively. Conclusion The positive rate and sensitivity of TCT in detecting mycobacterium from sputum, pleural effusion and bronchoalveolar lavage fluid were higher than those of Z-N staining, which is of important application value in clinical diagnosis.

Key words: Tuberculosis,pulmonary, Bronchoalveolar lavage fluid, Sputum, Pleural effusion, Diagnostic techniques and procedures, Histocytological preparation techniques, Comparative study