Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node Tuberculosis in Morocco, 2017: Cross-Sectional Study.
Morocco
histopathology
lymph node tuberculosis
positive predictive value
yield
Journal
JMIR public health and surveillance
ISSN: 2369-2960
Titre abrégé: JMIR Public Health Surveill
Pays: Canada
ID NLM: 101669345
Informations de publication
Date de publication:
09 Oct 2019
09 Oct 2019
Historique:
received:
03
04
2019
accepted:
17
08
2019
revised:
24
07
2019
entrez:
11
10
2019
pubmed:
11
10
2019
medline:
11
10
2019
Statut:
epublish
Résumé
The frequency of occurrence of extrapulmonary tuberculosis (EPTB) has been increasing globally over the last two decades. In Morocco, EPTB cases account for 46% of the patients reported with a new episode of tuberculosis (TB). Lymph node TB (LNTB) is the most common form of EPTB. In line with the guidelines of the National TB Program, the diagnosis is mainly based on clinical evidence, including histopathology. This study aimed to evaluate the yield of histopathology testing in the diagnosis of LNTB. This cross-sectional, prospective study was conducted among patients with cervical lymph node who were enrolled in the study from November 2016 to May 2017 in three regions of Morocco. We compared the outcomes of histopathological testing with those of bacteriology. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of histopathology testing were calculated. Culture and Xpert tests were used as the gold standard Laboratoty Testing. A total of 262 patients were enrolled in this study. The Se, Sp, PPV, and NPV of histopathology testing were 95.6% (129/135), 64.6% (82/127), 74.1% (129/174), and 93.2% (82/88), respectively, in the presence of granuloma with or without caseous necrosis and were 84.4% (114/135), 74.8% (95/127), 78.1% (114/146), and 81.9% (95/116), respectively, in the presence of granuloma with caseous necrosis. The granuloma with caseous necrosis was associated with increased PPV and Sp of histopathology testing (P<.05). The presence of the granuloma with caseous necrosis in the histopathological examination had significantly improved the yield of histopathology testing for the diagnosis of LNTB. The findings recommend to maintain histopathology testing in establishing the LNTB diagnosis and to explore other techniques to improve it.
Sections du résumé
BACKGROUND
BACKGROUND
The frequency of occurrence of extrapulmonary tuberculosis (EPTB) has been increasing globally over the last two decades. In Morocco, EPTB cases account for 46% of the patients reported with a new episode of tuberculosis (TB). Lymph node TB (LNTB) is the most common form of EPTB. In line with the guidelines of the National TB Program, the diagnosis is mainly based on clinical evidence, including histopathology.
OBJECTIVE
OBJECTIVE
This study aimed to evaluate the yield of histopathology testing in the diagnosis of LNTB.
METHODS
METHODS
This cross-sectional, prospective study was conducted among patients with cervical lymph node who were enrolled in the study from November 2016 to May 2017 in three regions of Morocco. We compared the outcomes of histopathological testing with those of bacteriology. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of histopathology testing were calculated. Culture and Xpert tests were used as the gold standard Laboratoty Testing.
RESULTS
RESULTS
A total of 262 patients were enrolled in this study. The Se, Sp, PPV, and NPV of histopathology testing were 95.6% (129/135), 64.6% (82/127), 74.1% (129/174), and 93.2% (82/88), respectively, in the presence of granuloma with or without caseous necrosis and were 84.4% (114/135), 74.8% (95/127), 78.1% (114/146), and 81.9% (95/116), respectively, in the presence of granuloma with caseous necrosis. The granuloma with caseous necrosis was associated with increased PPV and Sp of histopathology testing (P<.05).
CONCLUSIONS
CONCLUSIONS
The presence of the granuloma with caseous necrosis in the histopathological examination had significantly improved the yield of histopathology testing for the diagnosis of LNTB. The findings recommend to maintain histopathology testing in establishing the LNTB diagnosis and to explore other techniques to improve it.
Identifiants
pubmed: 31599732
pii: v5i4e14252
doi: 10.2196/14252
pmc: PMC6819008
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e14252Informations de copyright
©Kenza Bennani, Asmae Khattabi, Mohammed Akrim, Mohamed Mahtar, Najib Benmansour, Leila Essakalli Hossyni, Mehdi Karkouri, Nadia Cherradi, My Driss El Messaoudi, Ouafae Lahlou, Imad Cherkaoui, Yousef Khader, Abderrahmane Maaroufi, Salah-Eddine Ottmani. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 09.10.2019.
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