The diagnostic value of targeted next generation sequencing in sputum-free pulmonary tuberculosis patients

doi:10.19982/j.issn.1000-6621.20250127

Abstract

Abstract:

Objective: To evaluate the diagnostic value of targeted next generation sequencing (tNGS) for sputum-free pulmonary tuberculosis (TB) patients. Methods: We enrolled 149 sputum-free pulmonary TB patients derived from Beijing Chest Hospital, Capital Medical University from December, 2023 to March, 2024 for the collection of bronchoalveolar lavage fluids (BALFs), followed by culture, Xpert test, and tNGS. Based on microbiological reference standard (MRS) and clinical reference standard (CRS), the diagnostic capacity of these detection methods was compared. Results: The positive detection rates of culture, Xpert, and tNGS were 47.0% (70/149), 53.0% (79/149), and 89.3% (133/149), accordingly. Compared with MRS, the sensitivity of tNGS was 100.0% (81/81), which was similar to Xpert with 97.5% (79/81, χ²=2.025, P=0.155) and higher than culture with 86.4% (70/81, χ²=11.801, P=0.001). Based on CRS, tNGS exhibited the sensitivity of 96.3% (131/136) and the specificity of 84.6% (11/13). The sensitivity of tNGS was significantly higher than Xpert with 59.6% (81/136; χ²=53.459, P<0.001) and culture with 51.5% (70/136; χ²=70.921, P<0.001). Conclusion: tNGS showed an excellent diagnostic potential for sputum-free pulmonary TB patients, thus providing an alternative method for early TB diagnosis.

Key words: Tuberculosis, pulmonary, Sputum, Bronchoalveolar lavage fluid, Diagnostic techniques and procedures, Targeted next generation sequencing

CLC Number:

R521
R446

Yang Zeliang, Ma Zichun, Shang Yuanyuan, Shi Jin, Jing Wei, Pang Yu, Qin Lin. The diagnostic value of targeted next generation sequencing in sputum-free pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2025, 47(7): 878-883. doi: 10.19982/j.issn.1000-6621.20250127

Figures/Tables 5

References 18

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方法	微生物学参考标准		敏感度 (%,95%CI)	特异度 (%,95%CI)	阳性预测值 (%,95%CI)	阴性预测值 (%,95%CI)	符合率 (%,95%CI)
方法	阳性(例)	阴性(例)	敏感度 (%,95%CI)	特异度 (%,95%CI)	阳性预测值 (%,95%CI)	阴性预测值 (%,95%CI)	符合率 (%,95%CI)
tNGS技术			100.0 (94.4~100.0)	23.5 (14.4~43.4)	60.9 (52.0~69.1)	100.0 (75.9~100.0)	65.1 (57.2~72.3)
阳性	81	52
阴性	0	16
Xpert			97.5 (90.5~99.6)	100.0 (93.3~100.0)	100.0 (94.2~100.0)	97.1 (89.1~99.5)	98.7 (95.2~99.6)
阳性	79	0
阴性	2	68
培养			86.4 (76.6~92.7)	100.0 (93.3~100.0)	100.0 (93.5~100.0)	86.1 (76.0~92.5)	92.6 (87.3~95.8)
阳性	70	0
阴性	11	68

方法	临床参考标准		敏感度 (%,95%CI)	特异度 (%,95%CI)	阳性预测值 (%,95%CI)	阴性预测值 (%,95%CI)	符合率 (%)
方法	阳性(例)	阴性(例)	敏感度 (%,95%CI)	特异度 (%,95%CI)	阳性预测值 (%,95%CI)	阴性预测值 (%,95%CI)	符合率 (%)
tNGS技术			96.3 (91.2~98.6)	84.6 (53.7~97.3)	98.5 (94.1~99.7)	68.8 (41.5~87.9)	95.3 (90.6~97.7)
阳性	131	2
阴性	5	11
Xpert			59.6 (50.8~67.8)	100.0 (71.7~100.0)	100.0 (94.4~100.0)	19.1 (11.0~30.8)	63.1 (55.1~70.4)
阳性	81	0
阴性	55	13
培养			51.5 (42.8~60.1)	100.0 (71.7~100.0)	100.0 (93.5~100.0)	16.5 (9.4~26.9)	55.7 (47.7~63.4)
阳性	70	0
阴性	66	13