超灵敏脂阿拉伯甘露聚糖抗原尿液检测对HIV阴性肺结核的诊断价值OA

Objective To evaluate the diagnostic accuracy of an ultrasensitive electrochemiluminescence assay for detecting urinary lipoarabinomannan(LAM)in HIV-negative individuals with presumptive pulmonary tuberculosis.Methods HIV-negative patients(≥18 years)with suspected pulmonary tuberculosis admitted to Beijing Chest Hospital,Capital Medical University from January to May 2025.Sputum samples from all participants were subjected to smear microscopy,Xpert MTB/RIF assay,and mycobacterial culture.Concurrent urine samples were tested using the ultrasensitive LAM assay.Diagnostic performance was assessed against a composite reference standard for pulmonary tuberculosis diagnosis.Results Urine samples were collected from 280 HIV-negative adults with suspected pulmonary tuberculosis.Among them,144(51.4%)were microbiologically confirmed,64(22.9%)were clinically diagnosed,and 72(25.7%)were classified as non tuberculosis patients.Taking comprehensive diagnosis as the gold standard,the urinary LAM assay demonstrated a sensitivity of 51.44%(95%CI:44.65%-58.23%)and a specificity of 98.61%(95%CI:95.91%-100.00%).The sensitivity of combined urine LAM and sputum Xpert testing[76.08%(95%CI:70.29%-81.86%)]was higher than that of urine LAM testing alone.Conclusions The ultrasensitive urine LAM assay shows promising diagnostic accuracy and could offer a rapid tuberculosis diagnostic solution for HIV-negative patients with pulmonary tuberculosis.