Comparison of Histological, Microbiological, and Molecular Methods in Diagnosis of Patients with TBLN Having Different Anti-TB Treatment Background

• Published in: Biomedical and environmental sciences Vol. 30; no. 6; pp. 418 - 425
• Main Authors: CHE, Nan Ying, HUANG, Shao Jun, MA, Yan, HAN, Yi, LIU, Zi Chen, ZHANG, Chen, MU, Jing, ZHAO, Dan, QU, Yang, ZHANG, Hai Qing, LIU, Zhi Dong, XU, Shao Fa
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.06.2017; Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China%Clinical Center, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China%Department of Thoracic Surgery, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China
• Subjects: Adolescent; Adult; Aged; Anti-TB treatment; Antitubercular Agents - therapeutic use; Bacteriological Techniques; Drug resistance; Drug Resistance, Bacterial; Female; Humans; Male; Middle Aged; Molecular test; Mycobacterial culture; Tuberculosis, Lymph Node - diagnosis; Tuberculosis, Lymph Node - drug therapy; Tuberculosis, Lymph Node - microbiology; Tuberculous lymphadenitis; Young Adult; 分子生物学方法; 微生物学; 支气管; 治疗; 淋巴结; 组织学; 结核分枝杆菌; 诊断方法; Mycobacterial culture; Anti-TB treatment; Tuberculous lymphadenitis; Drug resistance; Molecular test
• ISSN: 0895-3988; 2214-0190
• DOI: 10.3967/bes2017.055

Objective The influence of anti-tuberculosis （TB） treatment history on tuberculous lymphadenitis （TBLN） diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-T8 treatment background were enrolled. All the samples were tested simultaneously by histology, ZiehI-Neelsen （ZN） staining, mycobacterial culture （culture）, Xpert MTB/RIF （xpert）, real-time PCR, and high-resolution melting curve PCR （HRM）. Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture （P 〈 0.0001）. In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert （P 〈 0.05）. However, the treatment history did not affect the performance of remaining tests （P 〉 0.05）. For rifampicin drug susceptibility test （DST）, the anti-T8 treatment showed only significant influence on the success rate of culture DST （P = 0.001）, but not on those of Xpert and HRM tests （P 〉 0.05）. Conclusion Other tests as welt as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.