{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:27:30Z","timestamp":1767713250673,"version":"3.41.2"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the diagnostic performance of laboratory assays on the ultrasound-guided core needle biopsy samples for diagnosis of extra-pulmonary tuberculosis (EPTB) in HIV-positive and HIV-negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 217 patients suspected to have EPTB underwent lesion biopsy from 2017 to 2020. Results of laboratory tests on the biopsy and non-biopsy samples were collected with clinical data for retrospective analysis of test utility. The calculated diagnostic accuracy of the tests was stratified according to the specimen types and HIV status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort contained 118 patients with a final positive diagnosis of extrapulmonary tuberculosis (EPTB group, 54.4%) and 99 finally diagnosed as without TB (non-EPTB group, 45.6%). The risk factor for EPTB was HIV co-infection (OR 2.22, 95% CI 1.17-4.28, <jats:italic>p<\/jats:italic> = 0.014). In biopsy samples, GeneXpert (Xpert) showed higher sensitivity (96.6% [91.6-98.7], <jats:italic>p<\/jats:italic> &amp;lt; 0.0001) than culture (56.1% [47.0-64.9]). Regardless of HIV status, Xpert had the highest sensitivity (&amp;gt;95%) and specificity (nearly 100%) of any methods. In non-biopsy samples, only T-SPOT.<jats:italic>TB<\/jats:italic> (T-SPOT) showed higher sensitivity than culture (90.9% [62.3-99.5] <jats:italic>vs<\/jats:italic> 35.3% [17.3-58.7], <jats:italic>p<\/jats:italic> = 0.0037). Furthermore, the sensitivities of Xpert were lower in non-biopsy samples (60.0% [23.1-92.9], <jats:italic>p<\/jats:italic> = 0.022) than in biopsy samples (100% [86.7-100]). Even in smear-negative biopsy samples, Xpert still had higher sensitivity than culture and retained high specificity (100% [95.7-100]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Superior performance of Xpert in diagnosing EPTB was observed regardless of HIV status and specimen types. Nevertheless, the biopsy samples still substantially facilitated the accurate diagnosis of extrapulmonary tuberculosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2023.1154939","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T15:40:21Z","timestamp":1679499621000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnosis of extrapulmonary tuberculosis by ultrasound-guided biopsy: A retrospective comparison study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jin-Chuan","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-fei","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-xiong","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Yong","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1002\/lary.24478","article-title":"Xpert MTB\/RIF for diagnosis of tuberculous cervical lymphadenitis in HIV-infected patients","volume":"124","author":"Ablanedo-Terrazas","year":"2014","journal-title":"Laryngoscope"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2882","DOI":"10.1002\/cncr.21541","article-title":"Extrapulmonary tuberculosis active infection misdiagnosed as cancer: Mycobacterium tuberculosis disease in patients at a comprehensive cancer center, (2001-2005)","volume":"104","author":"Aisenberg","year":"2005","journal-title":"Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/hiv.12251","article-title":"Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain, (1997-2010) according to HIV infection","volume":"16","author":"\u00c1lvaro-Meca","year":"2015","journal-title":"HIV Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12879-019-4749-x","article-title":"Diagnostic accuracy of the xpert MTB\/Rif ultra for tuberculosis adenitis","volume":"20","author":"Antel","year":"2020","journal-title":"BMC Infect. 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