Xpert MTB/RIF in the Diagnosis of Mediastinal Tuberculous Lymphadenitis by Endoscopic Ultrasound-Guided Needle Aspiration Techniques: A Systematic Review and Meta-Analysis
Articolo
Data di Pubblicazione:
2023
Citazione:
Xpert MTB/RIF in the Diagnosis of Mediastinal Tuberculous Lymphadenitis by Endoscopic Ultrasound-Guided Needle Aspiration Techniques: A Systematic Review and Meta-Analysis / M. Mondoni, L. Saderi, M.V. Puci, S. De Pascalis, B. Re, S. Centanni, G. Sotgiu. - In: RESPIRATION. - ISSN 1423-0356. - 102:3(2023), pp. 237-246. [10.1159/000528947]
Abstract:
Background: Lymphadenopathy is one of the most prevalent clinical manifestations of extrapulmonary tuberculosis. Endosonography is the recommended technique in the diagnostic work-up of mediastinal lymphadenopathies. Xpert MTB/RIF assay is a self-contained cartridge-based fully automated DNA testing platform which can accurately detect both tuberculosis and mycobacterial resistance to rifampicin. A few studies assessed its accuracy for mediastinal lymph node aspirates collected using endosonography. A systematic review of observational studies was performed to provide a pooled estimate of sensitivity and specificity of Xpert MTB/RIF in the diagnosis of mediastinal tuberculous lymphadenitis using endoscopic ultrasound-guided needle aspiration techniques. Methods: A search of the scientific evidence was carried out using PubMed, Embase, and Scopus. Articles describing observational studies on Xpert MTB/RIF in the diagnosis of mediastinal tuberculous lymphadenitis using endoscopic ultrasound-guided needle aspiration techniques were selected. Results: Eight studies met the inclusion criteria. The overall pooled sensitivity was 61% (95% CI = 55-68%; I2 = 66.3%; p = 0.004), overall pooled specificity was 89% (95% CI = 85-91%; I2 = 90.1%; p < 0.0001). Area under the sROC curve was 0.68. Only one study reported data on rifampin resistance detection and showed a sensitivity of 83.3% and a specificity of 16%. Conclusions: Xpert MTB/RIF shows a good accuracy in the diagnosis of mediastinal mycobacterial lymphadenitis by endosonographic needle aspiration techniques. It should be always recommended for suspected mediastinal tuberculosis.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Endobronchial ultrasound-guided transbronchial needle aspiration; Endosonography; Extrapulmonary TB; Mediastinal lymphadenitis; Nucleic acid amplification test; Rifampin resistance; Transesophageal endoscopic ultrasound with bronchoscope fine-needle aspiration; Tuberculosis; Xpert MTB/RIF
Elenco autori:
M. Mondoni, L. Saderi, M.V. Puci, S. De Pascalis, B. Re, S. Centanni, G. Sotgiu
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