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核酸扩增试验诊断结核淋巴结炎:系统性回顾 被引量：1

Nucleic acid amplification tests for the diagnosis of tuberculous lymphadenitis:a systematic review
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摘要 资料背景:淋巴结炎是结核病最常见的肺外表现。常规诊断方法,例如涂片镜检和培养,对于结核性淋巴结炎的诊断都不是非常精确。核酸扩增试验(NAAT)可以提供有益的辅助诊断。目的:通过系统回顾,评价NAAT方法诊断结核性淋巴结炎的实际效果。实验设计:我们进行了文献检索,发现36篇文章中包含了49个NAAT与结核性淋巴结炎参比标准的比较研究。每一个研究估计的灵敏度和特异性均采用树状图和概括性接收器工作特性曲线(SROC)来体现。结果:所有研究的质量大致相当,但很多研究的报告质量较差。各研究估计的NAAT的灵敏度(2%～100%)和特异性(28%～100%)差异很大,可能是由于研究的人群、质量和检测技术不同所致。商业化的NAAT试验应用20μl以上的模板,包含差异分析的报告提供了较高的诊断精确性。双盲、模板体积和差异分析可能解释一些结果不同的原因。结论:检测结核性淋巴结炎的NAAT研究所获得的结果高度可变,而且不一致,不可能成为临床确诊的指标。研究报告未标准化,而且通常包含的信息量不足。由于可能存在假阳性和假阴性结果,因此NAAT方法需与常规的方法联合应用,对临床可疑病例需依具体情况判断。
作者 P. Daley S. Thomas M. Pai 王博（译） 吴雪琼（校） 王雪静（审）
机构地区 Christian Medical College McGill University 不详
出处 《国际结核病与肺部疾病杂志》 2008年第3期119-129,共11页 The International Journal of Tuberculosis and Lung Disease
关键词 结核 淋巴结炎 核酸 扩增技术 NAAT PCR
分类号 R522 [医药卫生—内科学]
  • 相关文献

参考文献10

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同被引文献16

  • 1Y oon HJ, Song YG, Park WI, et al. Clinical manifestations and diagnosis of extrapulmonary tuberculosis. Y onsei MedJ, 2004, 45 :453461.
  • 2TeoJ,Jureen R, Chiang D, et al. Comparison of two nucleic acid amplification assays, the Xpert MTB/RIF assay and the amplified Mycobacterium tuberculosis Direct assay, for detection of Mycobacterium tuberculosis in respiratory and nonrespiratory specimens.J Clin Microbiol, 2011, 49 :3659-3662.
  • 3Richeldi L. An update on the diagnosis of tuberculosis infection. AmJ Respir Crit Care Med, 2006, 174:736-742.
  • 4Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician, 2005, 72:1761-1768.
  • 5Behr MA. BCG-different strains, different vaccines? Lancet Infect Dis, 2002, 2:86-92.
  • 6Schmidt NJ, Lennette EH, Ho HH. An apparently new enterovirus isolated from patients with disease of the central nervous system.J Infect Dis, 1974, 129 :304-309.
  • 7Scott CP, Dos Anjos Filho L, De Queiroz Mello FC, et al. Comparison of C ( 18 ) -carhoxypropylbetaine and standard N?acetyl-L-cysteine-NaOH processing of respiratory specimens for increasing tuberculosis smear sensitivity in Brazil.J Clin Microbiol, 2002,40 :3219-3222.
  • 8CloudJL, Shutt C, Aldous W, et al. Evaluation of a modified gen-probe amplified direct test for detection of Mycobacterium tuberculosis complex organisms in cerebrospinal fluid.J Clin Microbiol, 2004, 42:5341-5344.
  • 9Woods GL, BergmannJS, Williams-Bouyer N. Clinical Evaluation of the Gen-Probe amplified Mycobacterium tuberculosis direct test for rapid detection of Mycobacterium tuberculosis in select nonrespiratory specimens.J Clin Microbiol, 2001 , 39:747- 749.
  • 10Parsons LM, Brosch R, Cole ST, et al. Rapid and simple approach for identification of Mycobacterium tuberculosis complex isolates by PCR-based genomic deletion analysis.J Clin Microbiol, 2002, 40: 2339-2345.

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国际结核病与肺部疾病杂志
2008年 第3期

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