He Mea Kaua Hou no ka ʻIke ʻana i ka Maʻi Tuberculosis a me ka ʻIke ʻana i ke Kūʻē ʻana i ka Lāʻau Lapaʻau: He Hanana Hou i Hoʻolālā ʻia (tNGS) i Hoʻohui ʻia me ka Machine Learning no ka ʻIke ʻana i ka Maʻi Tuberculosis Hypersensitivity
Hōʻike moʻokalaleo: CCa: he kumu hoʻohālike diagnostics e pili ana i ka tNGS a me ke aʻo mīkini, kahi kūpono no ka poʻe me ka maʻi puʻupuʻu bacterial a me ka meningitis tuberculous.
Inoa o ke kumu noiʻi: Ka hoʻonohonoho ʻana i ka hanauna hou i hoʻopaʻa ʻia me ka maʻi tuberculous a me ke aʻo ʻana i ka mīkini: kahi hoʻolālā diagnostic ultra-sensitive no nā tubular pulmonary paucific a me ka meningitis tubular.
Manawa: 《Clinica Chimica Acta》
INĀ：6.5
Lā i hoʻopuka ʻia ai: Ianuali 2024
I hui pū ʻia me ke Kulanui o ke Kula ʻEpekema Kina a me ka Halemai ʻo Beijing Chest o ke Kulanui Lapaʻau ʻo Capital, ua hoʻokumu ʻo Macro & Micro-Test i kahi kumu hoʻohālike hōʻailona maʻi tuberculosis e pili ana i ka hanauna hou o ka ʻenehana sequencing i kuhikuhi ʻia (tNGS) a me ke ʻano aʻo mīkini, nāna i hāʻawi i ka ʻike ʻike kiʻekiʻe loa no ka maʻi tuberculosis me ka liʻiliʻi o nā bacteria a me ka meningitis tuberculous, hāʻawi i kahi ʻano hōʻailona hypersensitivity hou no ka hōʻailona lapaʻau o ʻelua ʻano maʻi tuberculosis, a kōkua i ka hōʻailona pololei, ka ʻike ʻana i ke kūʻē ʻana i ka lāʻau lapaʻau a me ka mālama ʻana i ka maʻi tuberculosis. I ka manawa like, ua ʻike ʻia hiki ke hoʻohana ʻia ka cfDNA plasma o ka mea maʻi ma ke ʻano he ʻano laʻana kūpono no ka laʻana lapaʻau i ka hōʻailona o TBM.
Ma kēia haʻawina, ua hoʻohana ʻia he 227 mau laʻana plasma a me nā laʻana wai cerebrospinal e hoʻokumu i ʻelua mau cohorts lapaʻau, kahi i hoʻohana ʻia ai nā laʻana cohort diagnostic laboratory e hoʻokumu i ke kumu hoʻohālike aʻo mīkini o ka maʻi tuberculosis, a ua hoʻohana ʻia nā laʻana cohort diagnostic clinical e hōʻoia i ke kumu hoʻohālike diagnostic i hoʻokumu ʻia. Ua kuhikuhi mua ʻia nā laʻana āpau e kahi waihona probe hopu i hoʻolālā kūikawā ʻia no Mycobacterium tuberculosis. A laila, ma muli o ka ʻikepili sequencing TB-tNGS, hoʻohana ʻia ke kumu hoʻohālike lāʻau hoʻoholo e hana i ka hōʻoia 5-fold ma nā hoʻonohonoho hoʻomaʻamaʻa a me ka hōʻoia o ka lālani diagnostic laboratory, a loaʻa nā paepae diagnostic o nā laʻana plasma a me nā laʻana wai cerebrospinal. Lawe ʻia ka paepae i loaʻa i loko o ʻelua mau hoʻonohonoho hoʻāʻo o ka lālani diagnostic clinical no ka ʻike ʻana, a loiloi ʻia ka hana diagnostic o ka mea aʻo e ka ROC curve. ʻO ka hope loa, ua loaʻa ke kumu hoʻohālike diagnostic o ka maʻi tuberculosis.
Kiʻi 1 kiʻikuhi hoʻolālā o ka hoʻolālā noiʻi
Nā Hualoaʻa: Wahi a nā paepae kikoʻī o ka hāpana DNA CSF (AUC = 0.974) a me ka hāpana cfDNA plasma (AUC = 0.908) i hoʻoholo ʻia ma kēia haʻawina, ma waena o 227 mau hāpana, ʻo ka ʻike o ka hāpana CSF he 97.01%, ʻo ka kikoʻī he 95.65%, a ʻo ka ʻike a me ka kikoʻī o ka hāpana plasma he 82.61% a me 86.36%. I ka nānā ʻana i 44 mau hāpana i hui pū ʻia o ka cfDNA plasma a me ka DNA wai cerebrospinal mai nā maʻi TBM, ʻo ke ʻano hana diagnostic o kēia haʻawina he kūlike kiʻekiʻe o 90.91% (40/44) i ka cfDNA plasma a me ka DNA wai cerebrospinal, a ʻo ka ʻike he 95.45% (42/44). I nā keiki me ka maʻi puʻupuʻu pulmonary, ʻoi aku ka ʻike o ke ʻano hana diagnostic o kēia haʻawina i nā hāpana plasma ma mua o nā hopena ʻike Xpert o nā hāpana wai gastric mai nā maʻi like (28.57% VS 15.38%).
Kiʻi 2 Hana loiloi o ke kumu hoʻohālike hōʻoia maʻi puʻupuʻu no nā laʻana heluna kanaka
Kiʻi 3 Nā hopena diagnostic o nā laʻana i hui pū ʻia
Hopena: Ua hoʻokumu ʻia kahi ʻano hana diagnostic hypersensitive no ka maʻi puʻupuʻu i loko o kēia haʻawina, hiki ke hāʻawi i kahi mea hana diagnostic me ka ʻike ʻike kiʻekiʻe loa no nā maʻi lapaʻau me ka oligobacillary tuberculosis (moʻomeheu maikaʻi ʻole). ʻO ka ʻike ʻana i ka maʻi puʻupuʻu hypersensitive e pili ana i ka plasma cfDNA he ʻano laʻana kūpono paha no ka ʻike ʻana i ka maʻi puʻupuʻu ikaika a me ka meningitis tuberculous (ʻoi aku ka maʻalahi o ka hōʻiliʻili ʻana i nā laʻana plasma ma mua o ka wai cerebrospinal no nā maʻi i manaʻo ʻia he maʻi puʻupuʻu lolo).
Loulou kumu: https://www.sciencedirect.com/science/article/pii/s0009898123004990? ma o%3Dihub
Hoʻolauna pōkole o nā huahana ʻike moʻo tuberculosis Macro & Micro-Test
Ma muli o ke kūlana paʻakikī o nā maʻi tuberculosis a me nā pono like ʻole, hāʻawi ʻo Macro & Micro-Test i kahi hoʻonohonoho piha o nā hopena NGS no ka unuhi ʻana i ka liquefaction mai nā laʻana sputum, ke kūkulu ʻana a me ke kaʻina hana o ka waihona puke Qualcomm, a me ka nānā ʻana i ka ʻikepili. Uhi nā huahana i ka ʻike wikiwiki ʻana i nā maʻi tuberculosis, ka ʻike ʻana i ke kūʻē ʻana o ka lāʻau lapaʻau i ka tuberculosis, ke ʻano o ka mycobacterium tuberculosis a me NTM, ka ʻike ʻana i ka hypersensitivity o ka bacteria-negative tuberculosis a me nā poʻe tuberculous, a pēlā aku.
Nā pahu ʻike serial no ka maʻi puʻupuʻu a me ka mycobacteria:
| Helu Mea | inoa huahana | ʻike hoʻāʻo huahana | ʻano laʻana | kumu hoʻohālike kūpono |
| HWTS-3012 | Mea hoʻokuʻu laʻana | Hoʻohana ʻia i ka mālama ʻana i ka liquefaction o nā hāpana sputum, ua loaʻa iā ia kahi helu moʻolelo papa mua, ʻo Sutong Machinery Equipment 20230047. | huʻa | |
| HWTS-NGS-P00021 | Pahu ʻike nui Qualcomm no ka maʻi puʻupuʻu hypersensitive (ʻano hopu probe) | ʻIke ʻana i ka hypersensitivity non-invasive (biops wai) no ka maʻi puʻuwai pulmonary bacteria-negative a me nā nodules lolo; Ua kālailai ʻia nā laʻana o ka poʻe i manaʻo ʻia ua loaʻa i ka maʻi tuberculosis a i ʻole non-tuberculosis mycobacteria e ka metagenomics sequencing hohonu kiʻekiʻe, a ua hāʻawi ʻia ka ʻike ʻike inā ua loaʻa ka maʻi tuberculosis a i ʻole non-tuberculosis mycobacteria a ua hāʻawi ʻia ka ʻike pale lāʻau mua o ka mycobacterium tuberculosis. | Koko peripheral, wai lavage alveolar, hydrothorax a me ascites, hāpana puncture focus, wai cerebrospinal. | Ka lua o ka hanauna |
| HWTS-NGS-T001 | Pahu ʻike no ke ʻano Mycobacterium a me ke kūʻē ʻana i ka lāʻau (ʻano hoʻonohonoho hoʻonui multiplex) | Hoʻāʻo ʻano Mycobacterium, me MTBC a me 187 NTM；ʻO ka ʻike ʻana i ke kūʻē ʻana o ka Mycobacterium tuberculosis i nā lāʻau lapaʻau e uhi ana i 13 mau lāʻau a me 16 mau wahi mutation koʻikoʻi o nā genes kūʻē i ka lāʻau lapaʻau. | ʻO ka sputum, ka wai holoi alveolar, hydrothorax a me ascites, ka hāpana puncture focus, ka wai cerebrospinal. | Kahua pālua o ka hanauna ʻelua/ʻekolu |
Nā mea koʻikoʻi: HWTS-NGS-T001 Mycobacterium typing and drug resistance detection kit (multiplex amplification method)
Hoʻolauna huahana
Hoʻokumu ʻia ka huahana ma luna o nā lāʻau lapaʻau laina mua a me ka lua i wehewehe ʻia ma nā alakaʻi lapaʻau WHO TB, nā macrolides a me nā aminoglycosides i hoʻohana pinepine ʻia ma nā alakaʻi lapaʻau NTM, a uhi nā wahi kūʻē lāʻau i nā hui āpau o nā wahi pili i ke kūʻē lāʻau ma ka papa inoa mutation complex WHO Mycobacterium tuberculosis, a me nā genes kūʻē lāʻau ʻē aʻe i hōʻike ʻia a me nā wahi mutation e like me ka noiʻi a me nā helu helu o nā palapala helu kiʻekiʻe ma ka home a ma waho.
Hoʻokumu ʻia ka ʻike ʻana i ke ʻano ma nā ʻano NTM i hōʻuluʻulu ʻia ma nā alakaʻi NTM i paʻi ʻia e ka Chinese Journal of Tuberculosis and Respiratory Diseases a me ka ʻaelike o nā loea. Hiki i nā primers typing i hoʻolālā ʻia ke hoʻonui, hoʻonohonoho a hoʻomaopopo i nā ʻano NTM he 190 a ʻoi.
Ma o ka ʻenehana hoʻonui PCR multiplex i kuhikuhi ʻia, ua hoʻonui ʻia nā genes genotyping a me nā genes pale lāʻau o Mycobacterium e ka multiplex PCR, a ua loaʻa ka hui amplicon o nā genes i manaʻo ʻia e ʻike ʻia. Hiki ke kūkulu ʻia nā huahana i hoʻonui ʻia i loko o nā hale waihona puke sequencing kiʻekiʻe o ka hanauna ʻelua a i ʻole ke kolu o ka hanauna, a hiki ke hoʻokomo ʻia nā kahua sequencing hanauna ʻelua a me ke kolu o ka hanauna i ka sequencing hohonu kiʻekiʻe e loaʻa ai ka ʻike sequence o nā genes i manaʻo ʻia. Ma ka hoʻohālikelike ʻana me nā mutations i ʻike ʻia i loko o ka waihona kuhikuhi i kūkulu ʻia (me ka papa inoa mutation complex WHO Mycobacterium tuberculosis a me kona pilina me ke kūʻē ʻana i ka lāʻau), ua hoʻoholo ʻia nā mutations e pili ana i ke kūʻē ʻana i ka lāʻau a i ʻole ka maʻalahi o nā lāʻau anti-tuberculosis. I hui pū ʻia me ka hopena lapaʻau sputum hāmama ponoʻī o Macro & Micro-Test, ua hoʻoponopono ʻia ka pilikia o ka pono haʻahaʻa o ka hoʻonui ʻana i ka waikawa nucleic o nā laʻana sputum lapaʻau (ʻumi manawa ʻoi aku ka kiʻekiʻe ma mua o nā ʻano kuʻuna), i hiki ke hoʻopili pololei ʻia ka ʻike ʻana i ke kūʻē ʻana i ka lāʻau i nā laʻana sputum lapaʻau.
Ka laulā ʻike huahana
34nā genes e pili ana i ke kū'ē ʻana i ka lāʻau lapaʻau o18nā lāʻau anti-tuberculosis a me6Ua ʻike ʻia nā lāʻau lapaʻau NTM, e uhi ana297nā wahi kū'ē i ka lāʻau; He ʻumi ʻano o Mycobacterium tuberculosis a ʻoi aku ma mua o190ua ʻike ʻia nā ʻano NTM.
Papa 1: ʻIke o 18+6 mau lāʻau lapaʻau +190+NTM
Ka pōmaikaʻi o ka huahana
Ka hiki ke hoʻololi pono i ke ʻano lapaʻau: hiki ke ʻike pololei ʻia nā hāpana sputum me ka mea hoʻoheheʻe ponoʻī me ka ʻole o ka moʻomeheu.
He maʻalahi ka hana hoʻokolohua: he maʻalahi ka pōʻai mua o ka hana hoʻonui, a ua hoʻopau ʻia ke kūkulu ʻana o ka hale waihona puke i 3 mau hola, kahi e hoʻomaikaʻi ai i ka pono o ka hana.
ʻO ke kikokiko piha a me ke kū'ē'ē lāʻau: e uhi ana i nā wahi kū'ē'ē kikokiko a me ka lāʻau o MTB a me NTM, ʻo ia nā kumu nui o ka hopohopo lapaʻau, ke kikokiko pololei a me ka ʻike ʻana i ke kū'ē'ē lāʻau, ke kākoʻo ʻana i nā polokalamu loiloi kūʻokoʻa, a me ka hana ʻana i nā hōʻike loiloi me hoʻokahi kaomi.
Hoʻohālikelike: hoʻohālikelike huahana, hoʻololi i nā kahua ILM a me MGI/ONT maʻamau.
Nā kikoʻī huahana
| Kōmike huahana | inoa huahana | Kahua ʻike | nā kikoʻī |
| HWTS-NGS-T001 | Pahu ʻike no ke ʻano Mycobacterium a me ke kūʻē ʻana i ka lāʻau (ʻano hoʻonui multiplex) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Ka manawa hoʻouna: Ian-23-2024