Yan QH, Chi JY, Zhang L, Xue F, Cui J, Kong HL. Value of ultrasound guided biopsy combined with Xpert Mycobacterium tuberculosis/resistance to rifampin assay in the diagnosis of chest wall tuberculosis. World J Clin Cases 2023; 11(28): 6698-6706 [PMID: 37901011 DOI: 10.12998/wjcc.v11.i28.6698]
Corresponding Author of This Article
Hai-Li Kong, Doctor, Chief Physician, Department of Medicine, Shandong Public Health Clinical Center, No. 46 Lishan, Jinan 250000, Shandong Province, China. 95367333@qq.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 6, 2023; 11(28): 6698-6706 Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6698
Value of ultrasound guided biopsy combined with Xpert Mycobacterium tuberculosis/resistance to rifampin assay in the diagnosis of chest wall tuberculosis
Qing-Hu Yan, Jing-Yu Chi, Lei Zhang, Feng Xue, Jia Cui, Hai-Li Kong
Qing-Hu Yan, Jia Cui, Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University, Jinan 250013, Shandong Province, China
Jing-Yu Chi, Hai-Li Kong, Department of Medicine, Shandong Public Health Clinical Center, Shandong University, Jinan 250013, Shandong Province, China
Lei Zhang, Department of Acupuncture and Massage, Shandong Provincial Third Hospital, Jinan 250000, Shandong Province, China
Feng Xue, Department of Radiology, Qilu Hospital, Shandong University, Jinan 250000, Shandong Province, China
Author contributions: Yan QH and Zhang L contributed to the conception of the study; Yan QH, Cui J, and Chi JY performed the experiment; Yan QH and Kong HL contributed significantly to analysis and manuscript preparation; Yan QH, Cui J, and Xue F performed the data analyses and wrote the manuscript; Xue F and Kong HL helped perform the analysis with constructive discussions; and all authors declare that they have no competing interest.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Shandong Public Health Clinical Center (Approval No. 2021XKYYEC-23).
Conflict-of-interest statement: The authors declare that they have no competing interest.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Data sharing statement: Data can be acquired from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Li Kong, Doctor, Chief Physician, Department of Medicine, Shandong Public Health Clinical Center, No. 46 Lishan, Jinan 250000, Shandong Province, China. 95367333@qq.com
Received: June 18, 2023 Peer-review started: June 18, 2023 First decision: August 10, 2023 Revised: August 23, 2023 Accepted: September 7, 2023 Article in press: September 7, 2023 Published online: October 6, 2023
Abstract
BACKGROUND
The thoracic wall lesions, particularly chest wall tuberculosis, and chest wall tumors and other pyogenic wall and actinomycetes infections, almost always present as a diagnostic challenge.
AIM
To explore the value of ultrasound-guided biopsy combined with the Xpert Mycobacterium tuberculosis/resistance to rifampin (MTB/RIF) assay to diagnose chest wall tuberculosis.
METHODS
We performed a retrospective study of patients with chest wall lesions from March 2018 to March 2021. All patients received the ultrasound-guided biopsy for pathology examination, acid-fast Bacillus staining, mycobacterial culture, and Xpert MTB/RIF analysis. The sensitivity, specificity, and area under the curve (AUC) were calculated for these diagnostic tests, either individually or combined. Rifampicin resistance results were compared between the mycobacterial culture and the Xpert MTB/RIF assay.
RESULTS
In 31 patients with the chest wall lesion biopsy, 22 patients were diagnosed with chest wall tuberculosis. Of them, 3, 6, and 21 patients tested positive for mycobacterial culture, acid-fast stain, and Xpert MTB/RIF assay, respectively. The rifampicin resistance results of the 3 culture-positive patients were consistent with their Xpert MTB/RIF assay results. When considering the sensitivity, specificity, and AUC value, the Xpert MTB/RIF assay (95.5%, 88.9%, and 0.92, respectively) was a better choice than the acid-fast Bacillus stain (27.3%, 100.0%, and 0.64, respectively) and mycobacterial culture (13.6%, 100.0%, 0.57, respectively). No complications were reported during the procedure.
CONCLUSION
Ultrasound guided biopsy combined with Xpert MTB/RIF has high value in the diagnosis of chest wall tuberculosis, and can also detect rifampicin resistance.
Core Tip: The thoracic wall lesions, particularly chest wall tuberculosis, and chest wall tumors and other pyogenic wall and actinomycetes infections, almost always present as a diagnostic challenge. Our study aims to explore the value of ultrasound guided biopsy combined with Xpert Mycobacterium tuberculosis/resistance to rifampin assay in the diagnosis of chest wall tuberculosis.
