Comparative analysis of clinical values of protein chip technique and other 4 detection methods for the diagnosis of tuberculosis

doi:10.3877/cma.j.issn.1674-6902.2017.04.012

Abstract

Abstract:

Objective

To evaluate the value of protein chip technique in the diagnosis of tuberculosis by comparative analysis.

Methods

According to lesion distribution, a total of 655 patients with tuberculosis were divided into three groups: pulmonary tuberculosis group, extrapulmonary tuberculosis group, and pulmonary&extrapulmonary tuberculosis group, with non-tuberculosis patients as the control group. Protein chip technique, TB-interferon gamma release assay (TB-IGRA), PCR assay for TB DNA(TB-PCR), bacteria-collecting smear method and bacterial culture method were applied to synchronous parallel detection for each group of samples. The positive detection rate, sensitivity and specificity of protein chip technique were compared with those of other 4 kinds of methods.

Results

The results showed that the positive rates of the 5 detection methods in tuberculosis group were significantly higher than those in non-tuberculosis control group. control group, 66.26% vs. 16.53% (protein chip technique); 91.30% vs. 10.08% (TB-IGRA); 67.02% vs. 30.24% (TB-PCR); 25.04% vs. 0% (bacteria-collecting smear method); and 25.65% vs. 0% (bacterial culture method). The differences were statistically significant (P<0.05). The positive rate and sensitivity of the detection of tuberculosis by protein chip technique was significantly higher than that of bacteria-collecting smear method and culture method, and the positive rate of TB detection was similar to that of TB-PCR, which was significantly lower than that of TB-IGRA. The specificity and positive predictive value of protein chip technique were significantly higher than those of TB-PCR, significantly lower than those of bacteria-collecting smear method and bacterial culture. As compared with TB-IGRA, protein chip technique was similar in specificity, positive predictive value was significantly lower. The negative predictive value of protein chip technique was significantly higher than that of TB-PCR, smear and bacterial culture, significantly lower than that of TB-IGRA, and the differences were statistically significant (P<0.05).

Conclusion

As the diagnostic techniques of tuberculosis with higher sensitivity and higher specificity, protein chip technique and TB-IGRA have complementary advantages and a good clinical application value.

Key words: Tuberculosis, Protein chip, Interferon gamma release assay, Diagnosis value

Yingkai Feng, Yong Wang, Zhenggu Huang, Xiaoli Zhao, Ying Liu. Comparative analysis of clinical values of protein chip technique and other 4 detection methods for the diagnosis of tuberculosis[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(04): 427-430.

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References 16

1	杨春娥，冯喜英. 结核病易感基因的研究现状[J/CD]. 中华肺部疾病杂志(电子版), 2016, 9(2): 207-209.
2	龚新记，李月华，姚丽丹，等. MLVA用于新疆部分地区结核分枝杆菌基因分型的初步研究[J/CD]. 中华肺部疾病杂志(电子版), 2017, 10(3): 304-308.
3	Mesquita ED, Gil-Santana L, Ramalho D, et al. Associations between systemic inflammation, mycobacterial loads in sputum and radiological improvement after treatment initiation in pulmonary TB patients from Brazil: a prospective cohort study[J]. BMC Infec Dis, 2016, 16: 368.
4	江红，臧国庆. 肺外结核[J]. 中华全科医学，2012, 10(1): 103-104.
5	许绍发，端木宏谨. 肺外结核的诊断和治疗[J]. 中华结核和呼吸杂志，1997, 20(3): 131-132.
6	陆震宇，杨明芳，陈纬. 结核病实验室诊断技术评价及其研究进展[J]. 中国卫生检验杂志，2017, 27(2): 301-304.
7	申明莉，王玉华. SAT技术用于快速检测肺结核的临床意义[J]. 中国继续医学教育，2016, 8(9): 18-20.
8	王静，刘立宾，岳永宁，等. RNA恒温扩增实时检测技术与荧光定量PCR联合检测肺泡灌洗液对痰涂阴性肺结核的快速诊断价值[J]. 中华医院感染学杂志，2017, 27(2): 300-304.
9	王长征，张平安，梅冰，等. γ-干扰素释放试验在肺结核诊断中的应用[J]. 公共卫生与预防医学，2015, 26(1): 49-52.
10	李锋，卢水华. γ干扰素释放试验在儿童结核病和潜伏结核感染中的诊断价值[J]. 中国防痨杂志，2015, 37(7): 732-735.
11	何启军，姚敏，吴多荣. 蛋白芯片技术诊断结核病的评价[J]. 中国热带医学，2010, 10(5): 523-524.
12	张立群，王云霞，周敏，等. 4种不同结核分支杆菌检测方法对结核病的诊断价值比较[J]. 中华医院感染学杂志，2010, 20(11): 1633-1635.
13	吴友根，杨兴萍，王军，等. 结核蛋白芯片检测诊断结核病的价值[J]. 中国感染与化疗杂志，2014, 3: 196-198.
14	张仁卿，邓长国. 结核蛋白芯片检测对结核病的诊断价值[J]. 四川医学，2016, 37(10): 1140-1143.
15	Zhu L, Liu Q, Martinez L, et al. Diagnostic value of GeneChip for detection of resistant Mycobacterium tuberculosis in patients with differing treatment histories[J]. J Clin Microbiol, 2015, 53(1): 131-135.
16	杜秀然，李春霞，刘锐，等. 结核生物蛋白芯片技术对肺结核的诊断价值[J]. 河北医药，2015, 1: 40-42.

组　别		例数	蛋白芯片技术[n(%)]	TB-IGRA[n(%)]	TB-PCR[n(%)]	集菌涂片法[n(%)]	结核菌培养法[n(%)]
结核组		655	434(66.26^a)	598(91.30^ab)	439(67.02^a)	164(25.04^abc)	168(25.65^ab)
?	肺结核组	432	290(67.13^a)	402(93.06^ab)	288(66.67^a)	132(30.56^abc)	116(26.85^ab)
?	肺外结核组	146	87(59.59^a)	131(89.73^ab)	98(67.12^a)	12(8.22^ab)	31(21.23^ab)
?	肺内外结核组	77	57(74.03^ac)	65(84.42^ab)	53(68.83^a)	20(25.97^abc)	21(27.27^ab)
非结核对照组		248	41(16.53)	25(10.08^b)	75(30.24)	0(0.00^b)	0(0.00^b)

组　别		例数	蛋白芯片技术[n(%)]	TB-IGRA[n(%)]	TB-PCR[n(%)]	集菌涂片法[n(%)]	结核菌培养法[n(%)]
结核组		655	434(66.26^a)	598(91.30^ab)	439(67.02^a)	164(25.04^abc)	168(25.65^ab)
?	肺结核组	432	290(67.13^a)	402(93.06^ab)	288(66.67^a)	132(30.56^abc)	116(26.85^ab)
?	肺外结核组	146	87(59.59^a)	131(89.73^ab)	98(67.12^a)	12(8.22^ab)	31(21.23^ab)
?	肺内外结核组	77	57(74.03^ac)	65(84.42^ab)	53(68.83^a)	20(25.97^abc)	21(27.27^ab)
非结核对照组		248	41(16.53)	25(10.08^b)	75(30.24)	0(0.00^b)	0(0.00^b)

方　法	灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)
蛋白芯片技术	66.26	83.47	91.37	48.36
TB-IGRA	91.30^a	89.92	95.99^a	79.64^a
TB-PCR	67.02	69.76^a	85.41^a	44.47
集菌涂片法	25.04^a	100.00^a	100.00^a	33.56^a
结核菌培养法	25.65^a	100.00^a	100.00^a	33.74^a

方　法	灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)
蛋白芯片技术	66.26	83.47	91.37	48.36
TB-IGRA	91.30^a	89.92	95.99^a	79.64^a
TB-PCR	67.02	69.76^a	85.41^a	44.47
集菌涂片法	25.04^a	100.00^a	100.00^a	33.56^a
结核菌培养法	25.65^a	100.00^a	100.00^a	33.74^a

方　法	肺结核组		肺外结核组
方　法	蛋白芯片技术	TB-IGRA	蛋白芯片技术	TB-IGRA
灵敏度(%)	67.13	93.06^a	59.59	89.73^a
特异度(%)	83.47	89.92	83.47	89.92
阳性预测值(%)	87.61	94.14^a	67.97	83.97^a
阴性预测值(%)	59.31	88.14^a	77.82	93.70^a
约登指数(Youden′sindex)	0.5060	0.8298^a	0.4306	0.7965^a

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