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首页> 外文期刊>JMIR public health and surveillance. >Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node Tuberculosis in Morocco, 2017: Cross-Sectional Study
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Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node Tuberculosis in Morocco, 2017: Cross-Sectional Study

机译：2017年摩洛哥淋巴结结核诊断中组织病理学产量的评估：跨领域研究

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Background: The frequency of occurrence of extrapulmonary tuberculosis (EPTB) has been increasing globally over the last two decades. In Morocco, EPTB cases account for 46% of the patients reported with a new episode of tuberculosis (TB). Lymph node TB (LNTB) is the most common form of EPTB. In line with the guidelines of the National TB Program, the diagnosis is mainly based on clinical evidence, including histopathology. Objective: This study aimed to evaluate the yield of histopathology testing in the diagnosis of LNTB. Methods: This cross-sectional, prospective study was conducted among patients with cervical lymph node who were enrolled in the study from November 2016 to May 2017 in three regions of Morocco. We compared the outcomes of histopathological testing with those of bacteriology. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of histopathology testing were calculated. Culture and Xpert tests were used as the gold standard Laboratoty Testing. Results: A total of 262 patients were enrolled in this study. The Se, Sp, PPV, and NPV of histopathology testing were 95.6% (129/135), 64.6% (82/127), 74.1% (129/174), and 93.2% (82/88), respectively, in the presence of granuloma with or without caseous necrosis and were 84.4% (114/135), 74.8% (95/127), 78.1% (114/146), and 81.9% (95/116), respectively, in the presence of granuloma with caseous necrosis. The granuloma with caseous necrosis was associated with increased PPV and Sp of histopathology testing (P.05). Conclusions: The presence of the granuloma with caseous necrosis in the histopathological examination had significantly improved the yield of histopathology testing for the diagnosis of LNTB. The findings recommend to maintain histopathology testing in establishing the LNTB diagnosis and to explore other techniques to improve it.
机译：背景：过去二十年来，全球肺外结核（EPTB）的发生频率一直在增加。在摩洛哥，EPTB病例占报告的新结核病患者的46％。淋巴结结核（LNTB）是EPTB的最常见形式。根据国家结核病规划指南，诊断主要基于临床证据，包括组织病理学。目的：本研究旨在评估组织病理学检查在诊断LNTB中的产率。方法：这项横断面，前瞻性研究于2016年11月至2017年5月在摩洛哥三个地区的宫颈淋巴结患者中进行。我们将组织病理学检查的结果与细菌学的结果进行了比较。计算组织病理学检测的敏感性（Se），特异性（Sp），阳性预测值（PPV）和阴性预测值（NPV）。文化和Xpert测试被用作黄金标准的“实验室测试”。结果：本研究共纳入262例患者。组织病理学检查的Se，Sp，PPV和NPV分别为95.6％（129/135），64.6％（82/127），74.1％（129/174）和93.2％（82/88）。肉芽肿伴或不伴干酪样坏死，在肉芽肿存在下分别为84.4％（114/135），74.8％（95/127），78.1％（114/146）和81.9％（95/116）干酪样坏死。干酪样肉芽肿性肉芽肿与组织病理学检查的PPV和Sp升高有关（P <.05）。结论：在组织病理学检查中，肉芽肿伴干酪样坏死显着提高了诊断LNTB的组织病理学检查的效率。该发现建议在建立LNTB诊断时继续进行组织病理学检查，并探索其他改进方法。

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