结核与肺部疾病杂志2025，Vol.6Issue(4)：413-419,7.DOI:10.19983/j.issn.2096-8493.20250024
纳米孔测序技术对非结核分枝杆菌肺病的诊断价值研究
Study on the diagnostic value of nanopore sequencing technology for non-tuberculous mycobacterial pulmonary disease
摘要
Abstract
Objective:To explore the diagnostic value of nanopore sequencing technology for detecting non-tuberculous mycobacterial pulmonary disease(NTM-PD)in bronchoalveolar lavage fluid(BALF).Methods:A total of 155 patients with suspected NTM-PD admitted to the Tuberculosis Department of Nanning Fourth People's Hospital from January 1,2022,to December 31,2024,were enrolled.BALF samples collected via bronchoscopy were subjected to mycobacterial culture and identification,fluorescence PCR melting curve method,and nanopore sequencing.The diagnostic efficiencies of these three methods were compared.Results:Among the patients,96 were diagnosed with NTM-PD(NTM-PD group)and 59 with non-NTM pulmonary diseases(including 29 cases of pulmonary tuberculosis and 30 cases of other pneumonias).The sensitivity,diagnostic concordance rate,and Kappa value of nanopore sequencing for NTM-PD diagnosis were 92.71％(95％CI:85.98％—96.75％),86.45％(95％CI:79.81％—91.56％),and 0.706(95％CI:0.586-0.808),The sensitivity of nanopore sequencing was significantly higher than that of mycobacterium identification by fluorescence PCR melting curve method(63.54％,95％CI:53.18％—73.09％;71.61％,95％CI:63.91％-78.49％;0.445,95％CI:0.350-0.618),mycobacterium culture and identification(63.54％,95％CI:53.18％—73.09％;74.84％,95％CI:67.35％-81.44％;0.515,95％CI:0.453-0.703),and the combination of the latter two methods(84.38％,95％CI:75.53％—90.94％;82.58％,95％CI:75.67％—88.23％;0.634,95％CI:0.523-0.761).However,the specificity of nanopore sequencing was 76.27％(95％CI:63.60％—86.37％),which was lower than that of mycobacterium identification by fluorescence PCR melting curve method(84.75％,95％CI:72.90％—92.71％),mycobacterium culture and identification(93.22％,95％CI:83.54％—98.01％),and the combination of the latter two methods(79.66％,95％CI:67.34％—89.14％).Conclusion:Nanopore sequencing technology has high diagnostic efficiency for NTM-PD and can directly identify bacterial species,but specificity issues should be considered in clinical application.关键词
纳米孔测序/非典型性细菌/分枝杆菌属/支气管肺泡灌洗液Key words
Nanopore sequencing/Atypical bacteria forms/Mycobacterium/Bronchoalveolar lavage fluid分类
医药卫生引用本文复制引用
黄高燕,苏深小,赵娟娟,梁宝元,蒙夏艳,何华伟..纳米孔测序技术对非结核分枝杆菌肺病的诊断价值研究[J].结核与肺部疾病杂志,2025,6(4):413-419,7.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20231204)Self-funded Research Project of Guangxi Zhuang Autonomous Region Health Commission(Z-A20231204) （Z-A20231204）
