Evaluation of Xpert MTB/RIF for the Diagnosis of Lymphatic Tuberculosis.

Hou-He Li,Gui-Lin Li,Jia-Qi Liang,Zhong-Wei Li,Zhi-Jian He,Tian-Ao Xie,Yong Xia,Xu-Guang Guo,Ye-Ling Liu,Xuan-Cheng Feng

doi:10.1155/2020/1968487

Abstract

Background The World Health Organization approved the use of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis DNA, which has significantly improved the diagnosis of tuberculosis. In this study, our main objective was to evaluate the diagnostic efficacy of Xpert MTB/RIF for lymphoid tuberculosis to determine whether Xpert MTB/RIF could be used as a routine detection method. Materials and Methods We searched four databases for the relevant literature published from May 2007 to December 2019. The quality of the literature was evaluated with reference to the evaluation criteria. Data that were extracted from the literature on Xpert MTB/RIF diagnosis of lymphatic tuberculosis were used to plot the summary receiver operating characteristic (SROC) curve, after which the software was used to combine and analyze the accuracy of these data. Results A total of 27 studies were included. The sensitivity of Xpert MTB/RIF for detecting lymphatic tuberculosis was 0.79 (95% CI (0.77, 0.81)), the specificity was 0.88 (95% CI (0.87, 0.90)), and the positive likelihood ratio (PLR) was 7.21 (95% CI (4.93, 10.55)). In addition, the negative likelihood ratio (NLR) was 0.25 (95% CI (0.19, 0.32)) and the diagnostic odds ratio (DOR) was 40.23 (95% CI (24.53, 65.98)). At the same time, we used the extracted data to make the SROC curve, obtaining the following parameters: area under the curve (AUC) = 0.9144, Q = 0.8470 (SE = 0.0163). Conclusion Xpert MTB/RIF has high accuracy in detecting lymphatic tuberculosis, and it can be used to quickly and easily diagnose lymphatic tuberculosis at an early stage as a general method.

Highlights

The World Health Organization approved the use of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis DNA, which has significantly improved the diagnosis of tuberculosis
The inclusion criteria were the following: (1) subjects: clinical specimens of lymph node tissues identified as tuberculous lymphadenitis by test methods, and tuberculosis detected in the lesions; (2) types of study: analytical test for diagnostic accuracy data for identification of bacterial species could be extracted from literature; only literature in English literature was considered; and (3) diagnostic test method: detection of M. tuberculosis using Xpert MTB/RIF
In the process of data extraction, we found that the gold standards are culture and composite reference standard (CRS), which even appears in some of the literature at the same time

Summary

Introduction

The World Health Organization approved the use of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis DNA, which has significantly improved the diagnosis of tuberculosis. Data that were extracted from the literature on Xpert MTB/RIF diagnosis of lymphatic tuberculosis were used to plot the summary receiver operating characteristic (SROC) curve, after which the software was used to combine and analyze the accuracy of these data. The sensitivity of Xpert MTB/RIF for detecting lymphatic tuberculosis was 0.79 (95% CI (0.77, 0.81)), the specificity was 0.88 (95% CI (0.87, 0.90)), and the positive likelihood ratio (PLR) was 7.21 (95% CI (4.93, 10.55)). Xpert MTB/RIF has high accuracy in detecting lymphatic tuberculosis, and it can be used to quickly and diagnose lymphatic tuberculosis at an early stage as a general method. In resource-poor countries with a high burden of lymphatic tuberculosis, quick and accurate detection and diagnosis of patients suffering from tuberculosis have become important factors in the control and treatment of lymphatic tuberculosis

Methods

Results

Conclusion