[1]冯永忠,林 媛,吴碧彤,等.纳米孔靶向二代测序（tNGS）技术在临床肺结核实验诊断中的价值研究[J].现代检验医学杂志,2026,41(02):5-9.[doi:10.3969/j.issn.1671-7414.2026.02.002]
　FENG Yongzhong,LIN Yuan,WU Bitong,et al.Analysis on the Value of Nanopore Targeted Next-Generation Sequencing Technology in Clinical Laboratory Diagnosis of Pulmonary Tuberculosis[J].Journal of Modern Laboratory Medicine,2026,41(02):5-9.[doi:10.3969/j.issn.1671-7414.2026.02.002]
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纳米孔靶向二代测序（tNGS）技术在临床肺结核实验诊断中的价值研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年02期
页码:
5-9
栏目:
论著
出版日期:
2026-03-15

文章信息/Info

Title:
Analysis on the Value of Nanopore Targeted Next-Generation Sequencing Technology in Clinical Laboratory Diagnosis of Pulmonary Tuberculosis
文章编号:
1671-7414（2026）02-005-05
作者:
冯永忠，林 媛，吴碧彤，蔡智群
广州市胸科医院肺外结核科，广州 510095
Author(s):
FENG Yongzhong，LIN Yuan，WU Bitong，CAI Zhiqun
Department of Extrapulmonary Tuberculosis, Guangzhou Chest Hospital, Guangzhou 510095, China
关键词:
纳米孔靶向二代测序; 肺结核; 结核分枝杆菌; 病原学检测
分类号:
R521；R446.19
DOI:
10.3969/j.issn.1671-7414.2026.02.002
文献标志码:
A
摘要:
目的?探讨纳米孔靶向二代测序(tNGS)技术在临床肺结核(PTB)实验诊断中的价值。方法采集2023年6月~2024年5月广州市胸科医院肺外结核科收治的210例疑似PTB患者的病例资料,以临床诊断为金标准确诊肺结核患者132例为PTB组,78例为非PTB组。收集所有研究对象的支气管肺泡灌洗液(BALF)样本,进行纳米孔tNGS、抗酸染色涂片、结核分枝杆菌(TB)-RNA检测、X-pert和分枝杆菌培养。比较两组基本资料,及不同检测方法的诊断效能。结果PTB组与非PTB组相比,在年龄、吸烟史方面差异具有统计学意义(χ2=5.294、8.226,均P<0.05),PTB组更倾向于年轻或老年人群,且吸烟者患PTB的风险显著高于非吸烟者;纳米孔tNGS诊断灵敏度与其他四种检测技术相比(75.76%vs30.30%、31.82%、43.94%、45.45%)、特异度与抗酸染色涂片、分枝杆菌培养比较(100.00%vs61.54%、83.33%)均较高,差异具有统计学意义(Z=28.375、15.483,均P<0.001)。经一致性检验发现,纳米孔tNGS与抗酸染色、TB-RNA检测、X-pert检测、分枝杆菌培养对PTB诊断的Kappa值分别为0.296、0.524、0.425、0.278。受试者操作特征(ROC)曲线下面积(AUC)结果显示,纳米孔tNGS的AUC高于其他各种检测技术,差异具有统计学意义(Z=18.426,P<0.001)。结论与传统病原学检测方法相比,基于纳米孔tNGS检测BALF样本诊断效能更好,与其他几种检测方法联合检测能够更精准的对PTB患者进行筛查。
Abstract:
Objective To explore the value of nanopore targeted next-generation sequencing (tNGS) technology in the laboratory diagnosis of clinical pulmonary tuberculosis (PTB). Methods A total of 210 suspected PTB patients admitted to the Department of Extrapulmonary Tuberculosis of Guangzhou Chest Hospital from June 2023 to May 2024 were collected. Based on clinical diagnostic criteria, 132 patients with confirmed PTB were classified as the PTB group, and 78 patients were classified as the non-PTB group. Bronchoalveolar lavage fluid (BALF) samples were collected from all subjects for nanopore tNGS, acid-fast staining smears, Mycobacterium tuberculosis (TB)-RNA detection, X-pert, and mycobacterium culture. Basic characteristics and diagnostic performance of different methods were compared between groups. Results There were significant differences in age and smoking history between the PTB group and the non-PTB group (χ2=5.294, 8.226, all P<0.05). The pulmonary tuberculosis group is more likely to be younger or older, and smokers had a significantly higher risk of PTB than non-smokers. The diagnostic sensitivity of nanopore tNGS was significantly higher than other detection technologies (75.76% vs 30.30%, 31.82%, 43.94%, 45.45%), and the specificity compared favorably with acid-fast staining smears and mycobacterium culture (100.00% vs 61.54%, 83.33%) with statistically significant differences (Z=28.375, 15.483, all P<0.001). Consistency testing revealed Kappa values for nanopore tNGS with acid-fast staining, TB-RNA detection, X-pert detection and mycobacterium culture in PTB diagnosis were 0.296, 0.524, 0.425 and 0.278, respectively. The results of area under the receiver operating characteristic (ROC) curve (AUC) showed that the AUC of nanopore tNGS was higher than those of other detection techniques (Z=18.426, P<0.001). Conclusions Compared with traditional pathogen detection methods, nanopore tNGS-based detection of BALF samples demonstrates superior diagnostic performance. Combined use with other detection methods enables more precise screening of PTB patients.

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备注/Memo

备注/Memo:
基金项目：广州市科技局市校（院）企联合资助项目（2024A03J0585）。
作者简介：冯永忠（1968-），男，本科，副主任医师 ，研究方向：结核病，E-mail：ffflz0524@163.com。
更新日期/Last Update: 2026-03-15