mNGS辅助诊断耶氏肺孢子菌肺炎在17例肺癌患者中的临床价值评估  

Evaluation of the Clinical Value of mNGS in the Auxiliary Diagnosis of Pneumocystis jirovecii Pneumonia in 17 Patients with Lung Cancer

作　　者：陈璐瑶 曲斌斌[2] 许亚慧 张春玲[2] 

机构地区：[1]青岛大学医学部,山东 青岛 [2]青岛大学附属青岛市中心医院呼吸与危重症医学科,山东 青岛

出　　处：《临床医学进展》2023年第10期16135-16141,共7页Advances in Clinical Medicine

摘　　要：目的:本研究旨在比较肺泡灌洗联合宏基因组二代测序(mNGS)与传统的病原检测方法在诊断肺癌合并耶氏肺孢子菌肺炎(PJP)方面的价值。方法:我们纳入了青岛大学附属青岛市中心医院2020年12月至2022年8月期间住院的17例肺癌患者的临床数据,这些患者通过mNGS辅助并经临床复合诊断为PJP。我们分析了这些患者的临床特征,并评估了mNGS在肺癌患者中诊断PJP的价值。结果:与1-3-β-D-葡聚糖测定和传统的病原菌涂片培养相比,mNGS对于耶氏肺孢子菌(Pj)的检出率明显更高。这表明mNGS可以作为辅助诊断肺癌患者PJP的工具。Pj序列数与CRP呈正相关(rs = 0.537, P = 0.026)。结论:肺泡灌洗联合mNGS在诊断肺癌患者PJP方面具有一定优势。相比传统的检测方法,mNGS更快速、检出率更高,并且在识别Pj共感染方面表现出明显的优越性。因此,mNGS在临床治疗上具有更大的指导作用,并可为患者预后带来一定的收益。Objective: This study aims to compare the value of bronchoalveolar lavage combined with meta-genomic next-generation sequencing (mNGS) and traditional pathogen detection methods in diag-nosing lung cancer complicated with Pneumocystis jirovecii pneumonia (PJP). Methods: We includ-ed clinical data from 17 hospitalized lung cancer patients at the Affiliated Qingdao Central Hospital of Qingdao University from December 2020 to August 2022. These patients were diagnosed with PJP through mNGS assistance and clinical composite diagnosis. We analyzed the clinical characteris-tics of these patients and evaluated the value of mNGS in diagnosing PJP in lung cancer patients. Results: Compared with 1-3-β-d-glucan assay and traditional pathogenic microorganism smear cul-ture, mNGS showed a significantly higher detection rate for Pneumocystis jirovecii (Pj). This indi-cates that mNGS can be used as an auxiliary tool for diagnosing PJP in lung cancer patients. The number of Pj sequences was positively correlated with CRP levels (rs = 0.537, P = 0.026). Conclusion: Bronchoalveolar lavage combined with mNGS has certain advantages in diagnosing PJP in lung can-cer patients. Compared to traditional detection methods, mNGS is faster, has a higher detection rate, and demonstrates significant superiority in identifying co-infections by Pj. Therefore, mNGS plays a greater guiding role in clinical treatment and can bring certain benefits to patient prognosis.

关 键 词：宏基因组二代测序 耶氏肺孢子菌肺炎 肺癌 免疫功能受损 

分 类 号：R73[医药卫生—肿瘤]