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

Nan Ying Che; Shao Jun Huang; Yan MA; Yi Han; Zi Chen Liu; Chen Zhang; Jing MU; Dan Zhao; Yang QU; Hai Qing Zhang; Zhi Dong Liu; Shao Fa XU

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

Author: Nan Ying CHE ¹ ; Shao Jun HUANG ² ; Yan MA ³ ; Yi HAN ⁴ ; Zi Chen LIU ¹ ; Chen ZHANG ¹ ; Jing MU ¹ ; Dan ZHAO ¹ ; Yang QU ¹ ; Hai Qing ZHANG ¹ ; Zhi Dong LIU ⁴ ; Shao Fa XU ⁴
Author Information

1. Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
2. Department of Pathology, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China
3. Clinical Center, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
4. Department of Thoracic Surgery, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Publication Type:Journal Article
Keywords: Anti-TB treatment; Drug resistance; Molecular test; Mycobacterial culture; Tuberculous lymphadenitis
MeSH: Adolescent; Adult; Aged; Antitubercular Agents; therapeutic use; Bacteriological Techniques; Drug Resistance, Bacterial; Female; Humans; Male; Middle Aged; Tuberculosis, Lymph Node; diagnosis; drug therapy; microbiology; Young Adult
From: Biomedical and Environmental Sciences 2017;30(6):418-425
CountryChina
Language:English
Abstract:
OBJECTIVEThe 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.
METHODSIn this study, suspected patients with TBLN and having different anti-TB treatment background were enrolled. All the samples were tested simultaneously by histology, Ziehl-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.
RESULTSIn 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-TB 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).
CONCLUSIONOther tests as well as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.