蛋白芯片技术与其他4种检测方法对结核病诊断价值的比较

目的通过比较分析,评估蛋白芯片技术对结核病的诊断价值。方法选择655例结核病患者按病变部位分为肺结核组、肺外结核组和肺结核并肺外结核组,以非结核患者作为对照。应用蛋白芯片技术、γ-干扰素释放试验(TB-IGRA)、TB DNA的PCR检测法(TB-PCR)、集菌涂片法、结核菌培养法5种检测方法对各组样本进行同步平行检测,并比较蛋白芯片技术与其他4种方法的检测阳性率、灵敏度、特异度等。结果上述5种检测方法在结核组的阳性率均显著高于非结核对照组,结核组和非结核对照组分别为66.26%、16.53%(蛋白芯片技术);91.30%、10.08%(TB-IGRA);67.02%、30.24%(TBPCR);25.04%、0.00%(集菌涂片法);25.65%、0.00%(结核菌培养法),差异均有统计学意义。蛋白芯片技术对结核的检出阳性率及灵敏度显著高于集菌涂片法和结核菌培养法,与TB-PCR检测阳性率类似,显著低于TB-IGRA。蛋白芯片技术的特异度及阳性预测值显著高于TB-PCR,显著低于集菌涂片法和结核菌培养;特异度与TB-IGRA类似,阳性预测值显著低于TB-IGRA;阴性预测值与TB-PCR阳性率类似,显著高于集菌涂片法和结核菌培养法,显著低于TB-IGRA,差异均有统计学意义(P0.05)。结论蛋白芯片技术和TB-IGRA作为诊断结核敏感度及特异度均较高的检测技术,二者取长补短,优势互补,具有良好的临床应用价值。

Comparative analysis of clinical values of protein chip technique and other 4 detection methods for the diagnosis of tuberculosis

Objective To evaluate the value of protein chip technique in the diagnosis of tuberculosis by comparative analysis.Methods According to lesion distribution, a total of 655 patients with tuberculosis were divided into three groups: pulmonary tuberculosis group, extrapulmonary tuberculosis group, and pulmonary&extrapulmonary tuberculosis group, with non-tuberculosis patients as the control group.Protein chip technique, TB-interferon gamma release assay (TB-IGRA), PCR assay for TB DNA(TB-PCR), bacteria-collecting smear method and bacterial culture method were applied to synchronous parallel detection for each group of samples.The positive detection rate, sensitivity and specificity of protein chip technique were compared with those of other 4 kinds of methods.Results The results showed that the positive rates of the 5 detection methods in tuberculosis group were significantly higher than those in non-tuberculosis control group.control group, 66.26％ vs.16.53％ (protein chip technique);91.30％ vs.10.08％ (TB-IGRA);67.02％ vs.30.24％ (TB-PCR);25.04％ vs.0％ (bacteria-collecting smear method);and 25.65％ vs.0％ (bacterial culture method).The differences were statistically significant (P<0.05).The positive rate and sensitivity of the detection of tuberculosis by protein chip technique was significantly higher than that of bacteria-collecting smear method and culture method, and the positive rate of TB detection was similar to that of TB-PCR, which was significantly lower than that of TB-IGRA.The specificity and positive predictive value of protein chip technique were significantly higher than those of TB-PCR, significantly lower than those of bacteria-collecting smear method and bacterial culture.As compared with TB-IGRA, protein chip technique was similar in specificity, positive predictive value was significantly lower.The negative predictive value of protein chip technique was significantly higher than that of TB-PCR, smear and bacterial culture, significantly lower than that of TB-IGRA, and the differences were statistically significant (P<0.05).Conclusion As the diagnostic techniques of tuberculosis with higher sensitivity and higher specificity, protein chip technique and TB-IGRA have complementary advantages and a good clinical application value.