评价XpertMTB/RIF法检测附睾结核的诊断效能。
方法:我们分析了2016年7月1日至2020年7月1日在我院接受手术治疗(附睾切除或附睾-睾丸切除)的疑似附睾结核或慢性附睾炎患者的84份样本。在本研究中使用复合参考标准(CRS)。我们确定了灵敏度,特异性,阳性预测值(PPV),负预测值(NPV),和附睾结核的XpertMTB/RIF测定的曲线下面积(AUC),并将其诊断准确性与结核分枝杆菌(MTB)培养试验在检测附睾结核中的准确性进行了比较。
结果:3例患者因数据不完整而被排除。与复合参考标准相比,灵敏度,特异性,PPV,NPV,附睾TB的XpertMTB/RIF测定的AUC为80.95%(69.09-89.75%);94.44%(72.71-99.86%);98.08%(89.74-99.95%);和58.62%(38.94-76.48%),分别,AUC为0.88(95%置信区间:0.79-0.94)。XpertMTB/RIF试验对附睾TB的诊断敏感性明显高于MTB培养试验。
结论:我们推荐XpertMTB/RIF测定法作为检测附睾TB的诊断方法。
To assess the diagnostic efficacy of Xpert MTB/RIF assay in detecting epididymal tuberculosis.
METHODS: We analyzed 84 samples from patients with suspected epididymal TB or chronic epididymitis who received surgical treatment (epididymal resection or epididymis-testicular resection) at our hospital between July 1, 2016 and July 1, 2020. A composite reference standard (CRS) was used in this study. We determined the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of the Xpert MTB/RIF assay for epididymal TB and compared its diagnostic accuracy with that of the Mycobacterium tuberculosis (MTB) culture test in detecting epididymal TB.
RESULTS: Three patients were excluded because of incomplete data. Comparing with the composite reference standard, the sensitivity, specificity, PPV, NPV, and AUC of Xpert MTB/RIF assay for epididymal TB were 80.95% (69.09-89.75%); 94.44% (72.71-99.86%); 98.08% (89.74-99.95%); and 58.62% (38.94-76.48%), respectively, with an AUC of 0.88 (95% confidence interval: 0.79-0.94). The diagnostic sensitivity of the Xpert MTB/RIF assay was significantly higher than that of the MTB culture test for epididymal TB.
CONCLUSIONS: We recommend the Xpert MTB/RIF assay as a diagnostic method for the detection of epididymal TB.