Efficacy of TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathyReportar como inadecuado




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BMC Pulmonary Medicine

, 15:166

First Online: 28 December 2015Received: 11 June 2015Accepted: 15 December 2015

Abstract

BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration EBUS-TBNA is widely used to perform mediastinal lymph node sampling. However, little information is available on polymerase chain reaction for Mycobacterium tuberculosis TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy IGL.

MethodsA retrospective study using a prospectively collected database was performed from January 2010 to December 2014 to evaluate the efficacy of the TB-PCR test using EBUS-TBNA samples in patients with IGL. During the study period, 87 consecutive patients with isolated intrathoracic lymphadenopathy who received EBUS-TBNA were registered and 46 patients with IGL were included.

ResultsOf the 46 patients with IGL, tuberculous lymphadenitis and sarcoidosis were diagnosed in 16 and 30 patients, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of TB-PCR for tuberculous lymphadenitis were 56, 100, 100, and 81 %, respectively. The overall diagnostic accuracy of TB-PCR for tuberculous lymphadenitis was 85 %. In addition, seven 17 % patients had non-diagnostic results from a histological examination and all of them had non-diagnostic microbiological results of an acid-fast bacilli smear and culture. Four 57 % of the seven patients with non-diagnostic results had positive TB-PCR results, and anti-tuberculosis treatment led to clinical and radiological improvement in all of the patients.

ConclusionsTB-PCR using EBUS-TBNA samples is a useful laboratory test for diagnosing IGL. Moreover, this technique can prevent further invasive evaluation in patients whose histological and microbiological tests are non-diagnostic.

KeywordsEndobronchial ultrasound-guided transbronchial needle aspiration Polymerase chain reaction Sarcoidosis Sensitivity and specificity Tuberculous lymphadenitis AbbreviationsCIconfidence interval

EBUS-TBNAendobronchial ultrasound-guided transbronchial needle aspiration

IGLintrathoracic granulomatous lymphadenopathy

TB-PCRpolymerase chain reaction for Mycobacterium tuberculosis

Jung Seop Eom and Jeong Ha Mok contributed equally to this work.

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Autor: Jung Seop Eom - Jeong Ha Mok - Min Ki Lee - Kwangha Lee - Min Ji Kim - Sun Mi Jang - Hae Jung Na - Seung Eon Song -

Fuente: https://link.springer.com/article/10.1186/s12890-015-0162-4







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