Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods

Hadir A. El-Mahallawy; Somia A. Eissa; Nefissa G. Rafeh; Ayman E.S. Salem; Soheir A. Eissa; Soheir A. Allian

doi:10.1016/j.jare.2010.03.008

Journal of Advanced Research (Apr 2010)

Tuberculosis in cancer patients: Role of newer techniques in relation to conventional diagnostic methods

Hadir A. El-Mahallawy,
Somia A. Eissa,
Nefissa G. Rafeh,
Ayman E.S. Salem,
Soheir A. Eissa,
Soheir A. Allian

Affiliations

Hadir A. El-Mahallawy: Department of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, Egypt
Somia A. Eissa: Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt
Nefissa G. Rafeh: Department of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, Egypt
Ayman E.S. Salem: Chest Department, Faculty of Medicine, Cairo University, Egypt
Soheir A. Eissa: Department of Clinical Pathology, National Cancer Institute, Cairo University, Kasr El-Aini Street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, Egypt
Soheir A. Allian: Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt

DOI: https://doi.org/10.1016/j.jare.2010.03.008
Journal volume & issue: Vol. 1, no. 2
pp. 157 – 162

Abstract

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The highly infectious nature of tuberculosis (TB) urges the need to increase the efficiency and rapidity of lab methods. The coexistence of TB and cancer was investigated using Mycobacterium tuberculosis direct test (MTD) and the mycobacteria growth indicator tube (MGIT), besides the conventional lab procedures. All assays were performed on 101 patients clinically suspected of having a mycobacterial infection. Over a period of 4 years, TB was confirmed in 32 patients with malignancy by applying the gold standard of considering patients with positive culture on Lowenstein–Jensen or MGIT or having any two or more positive tests as confirmed mycobacterial infection. Among the confirmed cases, the underlying malignant conditions were hematologic malignancies, bronchogenic carcinoma, and other solid tumors, in 14, 12, and 6 of the patients; respectively. TB developed during cancer chemotherapy in 18 cases (56%), and was discovered synchronously with malignancy in 14 (44%) patients. The ZN stain revealed acid-fast bacilli in 15 (47%) cases. The LJ culture was positive in 20 (63%) cases and MGIT was positive in 18 (56%) cases. Although the MTD test was positive in 18 (56%) of the confirmed TB cases; i.e., it was negative in 14 cases positive by other tests. There was a moderate agreement between results of LJ and MGIT, Kappa 0.396 and ZN and MGIT, Kappa 0.436. There was a weak agreement between results of LJ and MTD, ZN and MTD, Kappa 0.227 and 0.209; respectively; whereas, no agreement was calculated between MGIT and MTD Kappa 0.029. The calculation of the combined sensitivity of any two tests was 94%. TB is a major pathogen in patients with malignant diseases if clinically suspected. Little overlap between different technologies used necessitates the utilization of combination of tests together with consideration of key clinical characteristics to improve the diagnostic accuracy of TB.

Published in Journal of Advanced Research

ISSN: 2090-1232 (Print); 2090-1224 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General); Science: Science (General)
Website: http://www.journals.elsevier.com/journal-of-advanced-research/

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