Ib Riam Phom Tshiab Rau Kev Kuaj Mob Ntsws Thiab Kev Tshawb Pom Kev Tiv Thaiv Tshuaj: Ib Txoj Kev Tshawb Fawb Tshiab (tNGS) Ua Ke Nrog Kev Kawm Tshuab Rau Kev Kuaj Mob Ntsws Hypersensitivity
Daim ntawv qhia txog kev sau ntawv: CCa: tus qauv kuaj mob raws li tNGS thiab kev kawm tshuab, uas haum rau cov neeg uas muaj kab mob ntsws tsawg dua thiab mob ntsws meningitis.
Lub Npe Kawm Tiav: Kev Tshawb Fawb Txog Kab Mob Ntsws Thiab Kev Kawm Tshuab: Ib Txoj Kev Kuaj Mob Uas Muaj Kev Xav Tau Zoo Rau Cov Kab Mob Plab Hnyuv Thiab Kab Mob Me Me Hauv Plab.
Periodical: 'Clinica Chimica Acta'
YOG: 6.5
Hnub luam tawm: Lub Ib Hlis 2024
Ua ke nrog University of Chinese Academy of Sciences thiab Beijing Chest Hospital of Capital Medical University, Macro & Micro-Test tau tsim ib qho qauv kuaj mob ntsws raws li tiam tshiab ntawm targeted sequencing (tNGS) thev naus laus zis thiab tshuab kawm txuj ci, uas muab kev rhiab heev rau kev kuaj mob ntsws nrog ob peb tus kab mob thiab tuberculous meningitis, muab ib txoj kev kuaj mob hypersensitivity tshiab rau kev kuaj mob hauv tsev kho mob ntawm ob hom ntsws, thiab pab kuaj mob kom raug, kuaj mob tsis kam tshuaj thiab kho mob ntsws. Tib lub sijhawm, nws pom tias tus neeg mob lub plasma cfDNA tuaj yeem siv ua hom qauv tsim nyog rau kev kuaj mob hauv tsev kho mob hauv kev kuaj mob ntsws.
Hauv kev tshawb fawb no, 227 cov qauv ntshav thiab cov qauv kua hauv lub hlwb tau siv los tsim ob pawg neeg kho mob, uas cov qauv kuaj mob hauv chav kuaj mob tau siv los tsim cov qauv kev kawm tshuab ntawm kev kuaj mob ntsws, thiab cov qauv kuaj mob hauv chav kuaj mob tau siv los txheeb xyuas cov qauv kuaj mob uas tau tsim. Tag nrho cov qauv tau raug tsom thawj zaug los ntawm lub pas dej ntes tshwj xeeb uas tau tsim tshwj xeeb rau Mycobacterium tuberculosis. Tom qab ntawd, raws li cov ntaub ntawv TB-tNGS sequencing, cov qauv ntoo txiav txim siab tau siv los ua 5-zaug hla-kev lees paub ntawm cov txheej txheem kev cob qhia thiab kev lees paub ntawm cov kab kuaj mob hauv chav kuaj mob, thiab cov qhov txwv kev kuaj mob ntawm cov qauv ntshav thiab cov qauv kua hauv lub hlwb tau txais. Qhov txwv tau txais tau coj mus rau hauv ob pawg xeem ntawm cov kab kuaj mob hauv chav kuaj mob rau kev kuaj mob, thiab kev ua haujlwm kuaj mob ntawm tus neeg kawm tau ntsuas los ntawm ROC nkhaus. Thaum kawg, cov qauv kuaj mob ntsws tau txais.
Daim Duab 1 daim duab qhia txog kev tsim qauv tshawb fawb
Cov Txiaj Ntsig: Raws li qhov ntsuas tshwj xeeb ntawm cov qauv CSF DNA (AUC = 0.974) thiab cov qauv plasma cfDNA (AUC = 0.908) tau txiav txim siab hauv txoj kev tshawb fawb no, ntawm 227 cov qauv, qhov rhiab heev ntawm cov qauv CSF yog 97.01%, qhov tshwj xeeb yog 95.65%, thiab qhov rhiab heev thiab qhov tshwj xeeb ntawm cov qauv plasma yog 82.61% thiab 86.36%. Hauv kev tshuaj xyuas ntawm 44 cov qauv sib koom ua ke ntawm plasma cfDNA thiab cerebrospinal fluid DNA los ntawm cov neeg mob TBM, txoj kev kuaj mob ntawm txoj kev tshawb fawb no muaj qhov sib xws siab ntawm 90.91% (40/44) hauv plasma cfDNA thiab cerebrospinal fluid DNA, thiab qhov rhiab heev yog 95.45% (42/44). Hauv cov menyuam yaus uas muaj mob ntsws ntsws, txoj kev kuaj mob ntawm txoj kev tshawb fawb no muaj kev rhiab heev rau cov qauv plasma dua li cov txiaj ntsig Xpert ntawm cov qauv kua txiv gastric los ntawm tib cov neeg mob (28.57% VS 15.38%).
Daim Duab 2 Kev ua tau zoo ntawm kev tshuaj xyuas tus qauv kuaj mob ntsws rau cov qauv pej xeem
Daim Duab 3 Cov txiaj ntsig kuaj mob ntawm cov qauv sib koom ua ke
Xaus Lus: Ib txoj kev kuaj mob ntsws uas rhiab heev tau tsim los rau hauv txoj kev tshawb fawb no, uas tuaj yeem muab cov cuab yeej kuaj mob uas muaj kev rhiab heev rau cov neeg mob uas muaj oligobacillary tuberculosis (tsis pom zoo rau kev kuaj mob). Kev kuaj mob ntsws uas rhiab heev raws li plasma cfDNA yuav yog hom qauv tsim nyog rau kev kuaj mob ntsws uas nquag thiab mob ntsws meningitis (cov qauv plasma yooj yim dua los sau dua li cov kua cerebrospinal rau cov neeg mob uas xav tias muaj mob ntsws hauv hlwb).
Qhov txuas thawj: https://www.sciencedirect.com/science/article/pii/s0009898123004990? ntawm%3Dihub
Kev qhia luv luv ntawm Macro & Micro-Test tuberculosis series cov khoom kuaj pom
Vim tias cov neeg mob ntsws muaj ntau yam kev kuaj mob thiab ntau yam kev xav tau sib txawv, Macro & Micro-Test muab cov kev daws teeb meem NGS rau kev rho tawm cov hnoos qeev, kev tsim kho thiab kev txheeb xyuas cov ntaub ntawv ntawm Qualcomm, thiab kev tshuaj xyuas cov ntaub ntawv. Cov khoom no suav nrog kev kuaj mob ntsws sai, kev kuaj mob ntsws tsis kam tshuaj, kev ntaus hom kab mob mycobacterium ntsws thiab NTM, kev kuaj mob ntsws tsis haum tshuaj thiab cov neeg mob ntsws, thiab lwm yam.
Cov khoom siv kuaj mob ntsws thiab mycobacteria ua ntu zus:
| Khoom No. | lub npe khoom | cov ntsiab lus ntawm kev sim khoom | hom qauv | qauv siv tau |
| HWTS-3012 | Tus neeg sawv cev tso tawm qauv | Siv rau hauv kev kho cov kua qaub ntawm cov qauv hnoos qeev, tau txais tus lej sau thawj chav kawm, Sutong Machinery Equipment 20230047. | cov hnoos qeev | |
| HWTS-NGS-P00021 | Qualcomm cov khoom siv kuaj xyuas kom muaj nuj nqis rau tus kab mob ntsws uas rhiab heev (txheej txheem ntes cov ntaub ntawv) | Kev kuaj mob tsis yog phais (kua biopsy) rau cov kab mob ntsws thiab cov qog hauv lub hlwb uas tsis muaj kab mob bacterial-negative; Cov qauv ntawm cov neeg uas xav tias muaj kab mob ntsws lossis cov kab mob mycobacteria uas tsis yog ntsws tau raug tshuaj xyuas los ntawm kev ntsuas qhov tob tob, thiab cov ntaub ntawv kuaj pom seb puas muaj kab mob ntsws lossis cov kab mob mycobacteria uas tsis yog ntsws tau kis thiab cov ntaub ntawv tseem ceeb ntawm kab mob ntsws mycobacterium tau muab. | Cov ntshav peripheral, cov kua dej ntxuav alveolar, hydrothorax thiab ascites, cov qauv puncture, cov kua dej cerebrospinal. | tiam neeg thib ob |
| HWTS-NGS-T001 | Cov khoom siv kuaj mob Mycobacterium thiab tshuaj tiv thaiv kab mob (txheej txheem multiplex amplification sequencing) | Kev kuaj hom kab mob Mycobacterium, suav nrog MTBC thiab 187 NTM；Kev kuaj pom Mycobacterium tuberculosis tiv thaiv tshuaj suav nrog 13 cov tshuaj thiab 16 qhov chaw hloov pauv tseem ceeb ntawm cov noob tiv thaiv tshuaj. | Hnoos qeev, kua dej ntxuav alveolar, hydrothorax thiab ascites, cov qauv focus puncture, kua dej cerebrospinal. | Ob/peb tiam dual platform |
Cov Ntsiab Lus Tseem Ceeb: HWTS-NGS-T001 Mycobacterium typing thiab tshuaj tiv thaiv kab mob (multiplex amplification method)
Kev taw qhia txog khoom
Cov khoom no yog ua los ntawm cov tshuaj tseem ceeb thawj zaug thiab kab thib ob uas tau piav qhia hauv WHO cov lus qhia kho mob ntsws TB, macrolides thiab aminoglycosides uas feem ntau siv hauv NTM cov lus qhia kho mob, thiab cov chaw tiv thaiv tshuaj npog tag nrho ib pawg ntawm cov chaw cuam tshuam txog kev tiv thaiv tshuaj hauv WHO Mycobacterium tuberculosis complex mutation catalog, nrog rau lwm cov noob tiv thaiv tshuaj thiab cov chaw hloov pauv raws li kev tshawb nrhiav thiab cov ntaub ntawv ntawm cov ntaub ntawv tau qhab nia siab hauv tsev thiab txawv teb chaws.
Kev txheeb xyuas cov kab mob NTM yog raws li cov kab mob NTM uas tau muab sau ua ke hauv cov lus qhia NTM uas tau luam tawm los ntawm Chinese Journal of Tuberculosis and Respiratory Diseases thiab kev pom zoo ntawm cov kws tshaj lij. Cov primers uas tau tsim los no tuaj yeem ua kom nrov dua, sib lawv liag thiab sau ntawv rau ntau dua 190 hom NTM.
Los ntawm kev siv tshuab multiplex PCR amplification technology, cov noob caj noob ces genotyping thiab cov noob caj noob ces tiv taus tshuaj ntawm Mycobacterium tau raug amplified los ntawm multiplex PCR, thiab kev sib xyaw ua ke ntawm cov noob caj noob ces uas yuav tsum tau kuaj pom tau txais. Cov khoom amplified tuaj yeem tsim ua rau hauv tiam thib ob lossis tiam thib peb high-throughput sequencing libraries, thiab txhua tiam thib ob thiab tiam thib peb sequencing platforms tuaj yeem raug rau high-depth sequencing kom tau txais cov ntaub ntawv sequencing ntawm cov noob caj noob ces. Los ntawm kev sib piv nrog cov kev hloov pauv paub uas muaj nyob hauv cov ntaub ntawv siv ua ke (suav nrog WHO Mycobacterium tuberculosis complex mutation catalog thiab nws txoj kev sib raug zoo nrog kev tiv thaiv tshuaj), cov kev hloov pauv cuam tshuam nrog kev tiv thaiv tshuaj lossis kev cuam tshuam ntawm cov tshuaj tiv thaiv kab mob ntsws tau txiav txim siab. Ua ke nrog cov tshuaj kho mob hnoos qeev qhib tus kheej ntawm Macro & Micro-Test, qhov teeb meem ntawm kev ua haujlwm qis nucleic acid amplification ntawm cov qauv hnoos qeev hauv tsev kho mob (kaum npaug siab dua li ntawm cov txheej txheem ib txwm muaj) tau daws, yog li ntawd kev tiv thaiv tshuaj sequencing nrhiav tau tuaj yeem siv ncaj qha rau cov qauv hnoos qeev hauv tsev kho mob.
Ntau yam khoom nrhiav tau
34cov noob caj noob ces uas cuam tshuam nrog kev tiv thaiv tshuaj18cov tshuaj tiv thaiv kab mob ntsws thiab6Cov tshuaj NTM raug kuaj pom, suav nrog297cov chaw tiv thaiv tshuaj; Kaum hom Mycobacterium tuberculosis thiab ntau dua190cov hom NTM tau raug kuaj pom.
Rooj 1: Cov Ntaub Ntawv ntawm 18+6 Tshuaj +190+NTM
Qhov zoo ntawm cov khoom
Muaj peev xwm hloov kho tau zoo hauv kev kho mob: cov qauv hnoos qeev tuaj yeem kuaj pom ncaj qha nrog tus neeg sawv cev ua kua dej yam tsis muaj kab lis kev cai.
Qhov kev sim ua haujlwm yooj yim: thawj zaug ntawm kev ua haujlwm amplification yooj yim, thiab kev tsim kho tsev qiv ntawv tiav hauv 3 teev, uas ua rau kev ua haujlwm zoo dua.
Kev ntsuas hom ntawv thiab kev tiv thaiv tshuaj: npog cov chaw ntaus ntawv thiab kev tiv thaiv tshuaj ntawm MTB thiab NTM, uas yog cov ntsiab lus tseem ceeb ntawm kev txhawj xeeb hauv kev kho mob, kev ntsuas hom ntawv thiab kev tiv thaiv tshuaj kom raug, kev txhawb nqa software tshuaj xyuas ywj pheej, thiab tsim cov ntawv qhia tshuaj xyuas nrog ib qho nias.
Kev Sib Xws: kev sib xws ntawm cov khoom, hloov kho rau cov platform ILM thiab MGI / ONT.
Cov lus qhia txog khoom
| Tus lej khoom | lub npe khoom | Lub platform nrhiav pom | cov lus qhia tshwj xeeb |
| HWTS-NGS-T001 | Cov khoom siv kuaj mob Mycobacterium thiab tshuaj tiv thaiv kab mob (txoj kev multiplex amplification) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Lub sijhawm tshaj tawm: Lub Ib Hlis-23-2024