Intwaro Nshya yo Gusuzuma Igituntu no Kumenya Kurwanya Ibiyobyabwenge: Igisekuru gishya kigamije gukurikiranwa (tNGS) cyahujwe no Kwiga Imashini yo Kwiga Igituntu Hypersensitivity Diagnose
Raporo yubuvanganzo: CCa: icyitegererezo cyo gusuzuma gishingiye kuri tNGS no kwiga imashini, ikwiriye kubantu bafite igituntu gito cya bagiteri na meningite yigituntu.
Umutwe wa Theisis: Igituntu-cyibasiwe nigisekuru kizaza gikurikiranye hamwe no kwiga imashini: ingamba zo kwisuzumisha ultra-sensibilité yo kwisuzumisha ya pucific pulmonary tubulars na tubular meningitis.
Igihe cyagenwe: 《Clinica Chimica Acta》
NIBA ： 6.5
Itariki yatangarijwe: Mutarama 2024
Macro & Micro-Test ifatanije n’ishuri rikuru ry’ubumenyi ry’ubushinwa n’ibitaro bya Chest bya kaminuza y’ubuvuzi, Macro & Micro-Test yashyizeho uburyo bwo gusuzuma igituntu bushingiye ku gisekuru gishya cy’ikoranabuhanga rikurikirana (tNGS) hamwe n’uburyo bwo kwiga imashini, butanga ultra-high Kumenyekanisha igituntu hamwe na bagiteri nkeya na meningite yigituntu, byatanze uburyo bushya bwo gusuzuma hypersensitivite yo gusuzuma ivuriro ryubwoko bubiri bwigituntu, kandi bufasha gusuzuma neza, kumenya imiti no kuvura igituntu.Muri icyo gihe, usanga plasma cfDNA yumurwayi ishobora gukoreshwa nkicyitegererezo cyiza cyo gupima amavuriro mugupima TBM.
Muri ubu bushakashatsi, hifashishijwe urugero rwa plasma 227 hamwe n’amazi yo mu bwoko bwa cerebrospinal fluid yakoreshejwe mu gushiraho amavuriro abiri y’amavuriro, aho laboratoire yo kwisuzumisha ya laboratoire yakoreshejwe kugira ngo hashyizweho uburyo bwo kwiga imashini yo gusuzuma igituntu, naho ingero z’amavuriro zikoreshwa mu gusuzuma niba zashyizweho. icyitegererezo cyo gusuzuma.Ingero zose zabanje kwibasirwa nigikoresho cyateguwe cyo gufata pisine ya Mycobacterium igituntu.Noneho, hashingiwe ku makuru akurikirana ya TB-tNGS, icyitegererezo cyibiti cyakoreshejwe mugukora inshuro 5 kunyuranya kumahugurwa no kwemeza umurongo wa laboratoire yo kwisuzumisha, hanyuma hakaboneka ibipimo byo gupima urugero rwa plasma hamwe nicyitegererezo cyamazi ya cerebrospinal.Urutonde rwabonetse ruzanwa mubice bibiri byikizamini cyo kwisuzumisha kwa clinique kugirango tumenye, kandi imikorere yo gusuzuma abiga isuzumwa na ROC umurongo.Hanyuma, uburyo bwo gusuzuma igituntu bwabonetse.
Igishushanyo 1 igishushanyo mbonera cyubushakashatsi
Ibisubizo: Ukurikije ibipimo ntarengwa byerekana urugero rwa ADN ya CSF (AUC = 0.974) na plasma cfDNA (AUC = 0.908) byagenwe muri ubu bushakashatsi, mu byitegererezo 227, ibyiyumvo by'icyitegererezo cya CSF byari 97.01%, umwihariko ni 95,65%, na ibyiyumvo byihariye kandi byihariye bya plasma ni 82,61% na 86.36%.Mu isesengura ry’ingero 44 zahujwe na plasma cfDNA hamwe n’amazi ya cerebrospinal fluid ADN y’abarwayi ba TBM, ingamba zo gusuzuma ubu bushakashatsi zifite 90,91% (40/44) muri plasma cfDNA na ADN y’amazi yo mu bwonko, kandi ibyiyumvo ni 95.45% (42/44).Ku bana barwaye igituntu cy'igituntu, ingamba zo gusuzuma ubu bushakashatsi zumva cyane urugero rwa plasma kuruta ibisubizo bya Xpert byerekana ibisubizo by'umutobe wa gastrica uturuka ku barwayi bamwe (28.57% VS 15.38%).
Igishushanyo cya 2 Isesengura ryerekana uburyo bwo gusuzuma igituntu kuburugero rwabaturage
Igishushanyo cya 3 Ibisubizo byo gusuzuma ibisubizo byombi
Umwanzuro: Hashyizweho uburyo bukabije bwo gusuzuma indwara y’igituntu cyashyizweho muri ubu bushakashatsi, bushobora gutanga igikoresho cyo gusuzuma hamwe n’ubushakashatsi bukabije bw’abarwayi b’amavuriro bafite igituntu cya oligobacillary (umuco mubi).Kumenya igituntu kirenze urugero gishingiye kuri plasma cfDNA gishobora kuba ubwoko bwintangarugero mugupima igituntu gikora nigituntu cya meningite (icyitegererezo cya plasma kiroroshye gukusanya kuruta amazi ya cerebrospinal kubarwayi bakekwaho igituntu cyubwonko).
Ihuza ryumwimerere: https://www.sciencedirect.com/ubuhanga/article/pii/s0009898123004990?ukoresheje% 3Dihub
Intangiriro muri make ya Macro & Micro-Ikizamini cyigituntu cyerekana ibicuruzwa
Urebye ikibazo cyicyitegererezo cy’abarwayi b’igituntu n’ibikenewe bitandukanye, Macro & Micro-Test itanga urutonde rwuzuye rwibisubizo bya NGS byo kuvoma amazi mu ngero za spumum, kubaka isomero rya Qualcomm no kubikurikirana, no gusesengura amakuru.Ibicuruzwa bikubiyemo gusuzuma byihuse abarwayi b'igituntu, kurwanya ibiyobyabwenge byerekana igituntu, kwandika igituntu cya mycobacterium na NTM, gusuzuma hypersensitivite ya bagiteri-mbi y'igituntu n'abantu b'igituntu, n'ibindi.
Ibikoresho byerekana neza igituntu na mycobacteria:
| Ingingo Oya | izina RY'IGICURUZWA | ibizamini byo kugerageza ibicuruzwa | Ubwoko bw'icyitegererezo | icyitegererezo |
| HWTS-3012 | Icyitegererezo cyo kurekura | Yakoreshejwe mukuvura amazi ya spumum, yabonye numero yambere yo mucyiciro cya mbere, ibikoresho bya Sutong Machinery 20230047. | ururenda | |
| HWTS-NGS-P00021 | Qualcomm ingano yo kumenya ibikoresho bya hypercensitive igituntu (uburyo bwo gufata probe) | Kudatera imbaraga (biopsy y'amazi) hyperensitivite igaragara kuri bagiteri-mbi y'ibihaha y'igituntu na nodules y'ubwonko;Ingero z'abantu bakekwaho kuba baranduye igituntu cyangwa mycobacteria itari igituntu zasesenguwe na metagenomics ikurikirana yimbitse, kandi amakuru yo kumenya niba igituntu cyangwa mycobacteria itari igituntu yanduye ndetse n'amakuru y'ingenzi yo kurwanya ibiyobyabwenge bya mycobacterium igituntu. zatanzwe. | Amaraso ya periferique, amazi ya alveolar lavage, hydrothorax na asitite, icyerekezo cyibanze cyicyitegererezo, amazi ya cerebrospinal. | Igisekuru cya kabiri |
| HWTS-NGS-T001 | Kwandika Mycobacterium hamwe nibikoresho byo kurwanya ibiyobyabwenge (uburyo bukurikirana bwa multiplex amplification) | Ikizamini cyo kwandika Mycobacterium, harimo MTBC na 187 NTM；Kumenya kurwanya ibiyobyabwenge bya Mycobacterium igituntu gikubiyemo imiti 13 hamwe na 16 yibanze ya mutation ya genes irwanya ibiyobyabwenge. | Sputum, alveolar lavage fluid, hydrothorax na asitite, icyerekezo cyibanze cyicyitegererezo, cerebrospinal fluid. | Igice cya kabiri / icya gatatu cyibice bibiri |
Ibikurubikuru: HWTS-NGS-T001 Kwandika Mycobacterium hamwe nigikoresho cyo kurwanya ibiyobyabwenge (multiplex amplification method)
Kumenyekanisha ibicuruzwa
Igicuruzwa gishingiye ku biyobyabwenge nyamukuru byo ku murongo wa mbere n’uwa kabiri byasobanuwe mu mabwiriza yo kuvura igituntu cya OMS, macrolide na aminoglycoside bikunze gukoreshwa mu mabwiriza yo kuvura NTM, kandi ibibanza birwanya ibiyobyabwenge bikubiyemo itsinda rimwe ry’ibibanza bifitanye isano no kurwanya ibiyobyabwenge muri OMS Mycobacterium tuberculose complex catalogue ya mutation, kimwe nizindi raporo zavuzwe ko zirwanya ibiyobyabwenge hamwe na site za mutation ukurikije iperereza n’imibare y’ibitabo byatsindiye amanota menshi mu gihugu no hanze yacyo.
Kumenyekanisha kwandika bishingiye ku miterere ya NTM yavuzwe mu mabwiriza ya NTM yasohowe n'ikinyamakuru cyo mu Bushinwa cy’igituntu n'indwara z'ubuhumekero kandi byumvikanyweho n'impuguke.Igishushanyo mbonera cyanditse gishobora kwongerwaho, gukurikiranya no gusobanura amoko arenga 190 NTM.
Binyuze mu buhanga bugamije gukwirakwiza amikoro menshi ya PCR, genotyping gen hamwe na gen irwanya ibiyobyabwenge bya Mycobacterium byongerewe ingufu na multiplex PCR, hanyuma haboneka amplicon ihuza genes zigenewe kumenyekana.Ibicuruzwa byongerewe imbaraga birashobora kubakwa mubisekuru bya kabiri cyangwa ibisekuruza bya gatatu byinjira cyane mubitabo byamasomero bikurikirana, kandi ibisekuruza byose byakurikiranye ibisekuru byokwisekuru byisekuru bishobora gukurikiranwa byimbitse kugirango ubone amakuru akurikirana ya gen.Ugereranije n’imihindagurikire izwi ikubiye mu bubiko bwubatswe (harimo na OMS Mycobacterium tuberculose complex mutation catalog hamwe n’imikoranire yayo no kurwanya ibiyobyabwenge), hamenyekanye ihinduka ry’imihindagurikire y’ibiyobyabwenge cyangwa kwandura imiti igabanya ubukana.Hamwe nogukingura kwifunguro ryicyitegererezo cyo kuvura Macro & Micro-Test, ikibazo cya acide nucleic acide amplificatifike yubushakashatsi bwa sputum clinique (cyikubye inshuro icumi kurenza uburyo bwa gakondo) cyakemutse, kugirango hamenyekane uburyo bwo kurwanya ibiyobyabwenge bikurikirana. Byakoreshejwe muburyo butaziguye.
Urutonde rwo kumenya ibicuruzwa
34ibiyobyabwenge birwanya gen18imiti irwanya igituntu kandi6Habonetse ibiyobyabwenge bya NTM, bitwikiriye297ibibanza birwanya ibiyobyabwenge;Ubwoko icumi bwa Mycobacterium igituntu nibindi birenze190ubwoko bwa NTM bwaragaragaye.
Imbonerahamwe 1: Amakuru ya 18 + 6 Ibiyobyabwenge + 190 + NTM
Inyungu y'ibicuruzwa
Ihindagurika rikomeye ry’amavuriro: intangangore zirashobora gutahurwa neza na agent-yonyine yo kwisiga idafite umuco.
Igikorwa cyigeragezwa kiroroshye: icyiciro cya mbere cyibikorwa bya amplification biroroshye, kandi kubaka isomero birangira mumasaha 3, bitezimbere imikorere myiza.
Kwandika byimazeyo no kurwanya ibiyobyabwenge: bikubiyemo ibibanza byandika no kurwanya ibiyobyabwenge bya MTB na NTM, nizo ngingo zingenzi zita ku mavuriro, kwandika neza no kurwanya ibiyobyabwenge, gushyigikira porogaramu yisesengura yigenga, no gutanga raporo zisesengura ukanze rimwe.
Guhuza: guhuza ibicuruzwa, guhuza nuburyo rusange bwa ILM na MGI / ONT.
Ibisobanuro ku bicuruzwa
| Kode y'ibicuruzwa | izina RY'IGICURUZWA | Umwanya wo kumenya | Ibisobanuro |
| HWTS-NGS-T001 | Kwandika Mycobacterium hamwe no kurwanya ibiyobyabwenge (uburyo bwa multiplex amplification method) | ONT 、 Illumina 、 MGI 、 Salus pro | 16 / 96rxn |
Igihe cyo kohereza: Mutarama-23-2024