Preliminary assessment of the use of targeted next-generation sequencing technology for detecting lymph node tuberculosis using ultrasound-guided core needle biopsy specimens

PURPOSE: The current study aimed to evaluate the diagnostic utility of targeted next-generation sequencing (tNGS) technology in detecting lymph node tuberculosis (LNTB) using ultrasound-guided puncture core needle biopsy (CNB) samples. METHODS: This study was conducted on patients who underwent ultrasound-guided CNB operation. The samples obtained were used for the tNGS assay, mycobacterial tuberculosis (MTB) culture, Xpert MTB/RIF assay, and pathological examination. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of these assays were calculated. Then, their diagnostic efficacy was compared with that of the composite reference standard. RESULTS: The sensitivity, specificity, PPV, NPV, and AUC of the tNGS assay for detecting LNTB were 95.4%, 88.9%, 98.4%, 72.7%, and 0.921, respectively. Those of the MTB culture were 26.2%, 100.0%, 100.0%, 15.8%, and 0.631, respectively. Those of the Xpert MTB/RIF assay were 72.3%, 100.0%, 100.0%, 33.3%, and 0.862, respectively. Those of the pathological examination were 80.0%, 88.9%, 98.1%, 38.1%, and 0.844, respectively. Among the tests, the tNGS assay had the highest sensitivity, and the results significantly differed among the methods. CONCLUSION: The tNGS assay using CNB samples had a superior diagnostic efficacy for diagnosing LNTB. Hence, it has potential in clinical application. CLINICAL TRIAL: Not applicable.