Meta-analysis of the application value of metagenomic next-generation sequencing technology in the diagnosis of pulmonary tuberculosis

doi:10.3969/j.issn.1004-583X.2023.05.001

Abstract

Abstract:

Objective To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) technology in different clinical specimens for pulmonary tuberculosis (PTB). Methods Relevant researches on the diagnosis of PTB by using mNGS included in PubMed, Embase, The Cochrane Library, CNKI, Wanfang and Vip and other databases for published from the establishment to November 2022were searched. After strict screening and quality evaluation, the literatures were screened by two researchers independently, followed by data extraction and risk assessment of inclusion study bias. StataSE16 software and Revman5.3 software were used for meta-analysis. Results A total of 11 eligible literature and 1995 patients were included in the meta-analysis. The results showed that the sensitivity and specificity of mNGS for PTB diagnosis in lung specimens was 70% (95% CI: 58%-79%) and 99% (95% CI: 98%-100%), positive likelihood ratio (PLR) was 106.9 (95% CI: 31.1-366.6), negative likelihood ratio(NLR) was 0.31 (95% CI: 0.21-0.43), diagnostic odds ratio(DOR) was 350 (95% CI: 81-1512) and the area under curve(AUC) was 0.97. The sensitivity, specificity, PLR, NLR, DOR, and AUC of mNGS for PTB diagnosis in bronchoalveolar lavage fluid (BALF) were 71% (95% CI: 55%-83%), 99% (95% CI: 97%-100%), 76.4 (95% CI: 26.6-218.9), 0.30 (95% CI: 0.18-0.48), 258 (95% CI: 75-895), and 0.99, respectively. The sensitivity and specificity of mNGS for PTB diagnosis in lung tissues were 81% (95% CI: 69%-89%) and 97% (95% CI: 88%-99%), PLR was 26.0 (95% CI: 6.6-102.4), NLR was 0.19 (95% CI: 0.11-0.33), DOR was 135 (95%CI: 29-639), and AUC was 0.97. Conclusion Application of mNGS technology exerts high diagnostic value for PTB, especially for sputum-negative PTB, which can be used as an auxiliary tool for rapid diagnosis of PTB.

Key words: tuberculosis, pulmonary, metagenomic next-generation sequencing, diagnostic value, meta-analysis

CLC Number:

R521

Wolazihan Madeniyati, Dilixiati Tuerdimaimaiti, Li Mengchen, Baihetinisha Tuerdi. Meta-analysis of the application value of metagenomic next-generation sequencing technology in the diagnosis of pulmonary tuberculosis[J]. Clinical Focus, 2023, 38(5): 389-398.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.05.001

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I5/389

Figures/Tables 13

References 29

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第一作者	年份	PTB组(例)	非PTB组(例)	诊断标准	研究方法	mNGS测序平台	标本类型
Zhou等^[11]	2019	13	14	临床/病原	前瞻性研究	BGISEQ	肺标本
Shi等^[12]	2020	48	62	临床/病原	前瞻性研究	其他	BALF
Chen等^[13]	2020	17	20	临床/病原	回顾性研究	BGISEQ	BALF/肺标本
Jin等^[14]	2020	53	424	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
Liu等^[15]	2021	142	111	临床/病原	回顾性研究	BGISEQ	BALF
Zhu等^[16]	2021	46	61	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
王春等^[17]	2021	103	24	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
孙雯雯等^[18]	2021	100	105	临床/病原	回顾性研究	BGISEQ	肺标本
赵素娥等^[19]	2022	95	60	临床/病原	回顾性研究	未知	BALF
Xu等^[20]	2022	71	23	临床/病原	回顾性研究	其他	BALF
Fu等^[21]	2022	46	357	临床/病原	回顾性研究	其他	肺标本

第一作者	年份	PTB组(例)	非PTB组(例)	诊断标准	研究方法	mNGS测序平台	标本类型
Zhou等^[11]	2019	13	14	临床/病原	前瞻性研究	BGISEQ	肺标本
Shi等^[12]	2020	48	62	临床/病原	前瞻性研究	其他	BALF
Chen等^[13]	2020	17	20	临床/病原	回顾性研究	BGISEQ	BALF/肺标本
Jin等^[14]	2020	53	424	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
Liu等^[15]	2021	142	111	临床/病原	回顾性研究	BGISEQ	BALF
Zhu等^[16]	2021	46	61	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
王春等^[17]	2021	103	24	临床/病原	回顾性研究	BGISEQ	BALF/肺组织/肺标本
孙雯雯等^[18]	2021	100	105	临床/病原	回顾性研究	BGISEQ	肺标本
赵素娥等^[19]	2022	95	60	临床/病原	回顾性研究	未知	BALF
Xu等^[20]	2022	71	23	临床/病原	回顾性研究	其他	BALF
Fu等^[21]	2022	46	357	临床/病原	回顾性研究	其他	肺标本

标本类型	敏感度(95% CI)	特异度(95% CI)	PLR(95% CI)	NLR(95% CI)	DOR(95% CI)	AUC(95% CI)
肺标本	70%(58%~79%)	99%(98%~100%)	106.9(31.1~366.6)	0.31(0.21~0.43)	350(81~1512)	0.97(0.95~0.98)
BALF	71%(55%~83%)	99%(97%~100%)	76.4(26.6~218.9)	0.30(0.18~0.48)	258(75~895)	0.99(0.98~1.00)
肺组织	81%(69%~89%)	97%(88%~99%)	26.0(6.6~102.4)	0.19(0.11~0.33)	135(29~639)	0.97(0.95~0.98)

标本类型	敏感度(95% CI)	特异度(95% CI)	PLR(95% CI)	NLR(95% CI)	DOR(95% CI)	AUC(95% CI)
肺标本	70%(58%~79%)	99%(98%~100%)	106.9(31.1~366.6)	0.31(0.21~0.43)	350(81~1512)	0.97(0.95~0.98)
BALF	71%(55%~83%)	99%(97%~100%)	76.4(26.6~218.9)	0.30(0.18~0.48)	258(75~895)	0.99(0.98~1.00)
肺组织	81%(69%~89%)	97%(88%~99%)	26.0(6.6~102.4)	0.19(0.11~0.33)	135(29~639)	0.97(0.95~0.98)

	分组	研究数量	敏感度(95%CI)	P值
研究类型	回顾性分析前瞻性研究	7 1	71%(58%~83%) 67%(54%~79%)	0.674
测序平台	BGISEQ 其他	5 3	70%(52%~88%) 72%(47%~97%)	0.882
痰涂片情况	阴性阳性	2 6	89%(81%~97%) 64%(54%~73%)	<0.05