Clinical Application Value Of Gene Chip In The Diagnosis Of Tuberculosis

ObjectiveTo explore the clinical application value of gene chip technology in diagnosis of pulmonary tuberculosis.MethodsSelection in 648 patients with suspected pulmonary tuberculosis who were hospitalized in our hospital from February 2016 to September 2017,The specimens of the above patients were detected by gene chip method,Roche culture method and Liquid-based interlayer vessel technique.The positive rate,sensitivity,specificity,missed diagnosis rate,misdiagnosis rate,coincidence rate,positive predictive value and negative predictive value of the three detection methods were compared.Then using the Roche culture method and clinical diagnosis as the gold standard,the test results were checked for consistency,and the value of gene chip technology in the diagnosis of tuberculosis was evaluated.Analyzing the detection rate of Mycobacterium tuberculosis in different types of specimens and evaluating the effect of specimen types on the test results.Results(1)The positive rate of gene chip method,Roche culture method andLiquid-based interlayer vessel technique and was 58.3%(378/648)?51.4%(333/648)? 36.7%(238/648),The difference was statistically significant(P<0.05);(2)Considering the Roche culture method as gold standard,The sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of the gene chip method were 95.5%,81%,88.43%,84.13%,94.44%,and Kappa=0.767(P<0.05).The Liquid-based interlayer vessel technique was 65.2%,93.3%,78.86%,91.18%,71.7%,Kappa=0.623(P<0.05).(3)Of the 648 patients,435 were diagnosed with tuberculosis and 213 were non-tuberculosis patients based on clinical symptoms,imaging,and laboratory tests.Using the clinical diagnosis as the gold standard,the specificity of the gene chip method,Roche culture method and the Liquid-based interlayer vessel technique were all 100%;the misdiagnosis rate were 0;the sensitivity was 86.9%,76.6% and 54.7%respectively.The rate of missed diagnosis was 13.1%,23.4% and 45.3%respectively.The agreement with the clinical diagnosis(Kappa)was 0.813,0.682,and 0.443 respectively(P<0.05).The difference was statistically significant.(4)The positive rates of different types of specimens using gene chip method were: Bronchoalveolar lavage fluid(hereinafter referred to as "BALF")72%,sputum 54.4%,pleural effusion 31.1%;Roche culture method positive rate:BALF 62.6%,sputum 48.6%,pleural effusion27%.The positive rate of the Liquid-based interlayer vessel technique was51.8% for BALF,30.8% for sputum,and 13.5% for pleural effusion.Thepositive rates of different specimens from high to low were BALF,sputum,and pleural effusion.(5)The positive rate of pleural effusion using gene chip method,Roche culture method,Liquid-based interlayer vessel technique was 31.1%,27%,and 13.5% respectively.The positive rate of gene chip method was higher than that of Liquid-based interlayer vessel technique,the difference was statistically significant(P<0.05);there was no significant difference between the positive rate of gene chip method and Roche culture method(P>0.05).Conclusion(1)The gene chip technique has a high positive rate for BALF,sputum,and pleural effusion specimens,and has good consistency with the Roche culture method.It can quickly and accurately detect Mycobacterium tuberculosis and can be used as pulmonary tuberculosis Rapid diagnosis of effective means.(2)BALF has a high positive detection rate and can be preferably used for the diagnosis of tuberculosis.(3)Detection of Mycobacterium tuberculosis by pleural effusion using gene chip method has high positive rate,short time and high accuracy,which can provide a basis for rapid diagnosis of tuberculous pleurisy.