This study aimed to find significant factors associated with tuberculosis (TB) infection and disease development. The participants were from National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI). The tuberculosis infection was defined as a positive QuantiFERON-TB Gold-In-Tube (QFT-GIT). The Least Absolute Shrinkage and Selection Operator (LASSO) model was used to screen variables associated with QFT-GIT among 23 laboratory measures. Then the logistic regression analyses were performed to assess the independent factors, followed by a comprehensive nomogram model construction. Receiver operating characteristic (ROC) and Decision Curve (DCA) analyses were used to assess the performance of comprehensive model on QFT-GIT result and death risk. Of 5256 individuals included, 521 individuals had positive QFT-GIT. LASSO analysis indicated that 11 variables were associated with QFT-GIT result, and logistic regression analyses further found sodium and monocyte-to-lymphocyte ratio (MLR) were independent factors. After adjusting for potential confounders, the correlation of sodium and MLR with QFT-GIT result was still observed. The comprehensive model based on sodium, MLR, and important clinical characteristics can predict 0.8 probability of positive QFT-GIT and achieve more clinical net benefit. ROC analysis by training and validation sets showed the favorable prediction performance. Comprehensive model also presented favorable performance in evaluating the death risk of individuals with positive QFT-GIT. We also found MLR rather than sodium was independently related to the death risk. Both MLR itself and comprehensive model were all significantly related to the positive QFT-GIT and death risk, which might participate in the initiation and progression of tuberculosis infection.

Background: To investigate the diagnostic value of bronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) in tuberculous peripheral pulmonary lesions.Methods: A total of 770 patients who completed CT imaging and ultrasound bronchoscopy were retrospectively analyzed. All patients underwent biopsy sampling as well as alveolar lavage under the guidance of ultrasound. Pathological analysis and molecular biological detection of pulmonary tuberculosis were performed in both pathological tissues and bronchoalveolar lavage fluid (BALF), and the diagnostic positive rate and diagnostic sensitivity were statistically analyzed.Results: Of the 44 patients who were found to have lesions by EBUS-TBLB, 26 patients were able to achieve a definite diagnosis of PPLs, with an overall diagnostic yield of 59.1%. Of the 33 patients with all diagnosed benign lesions, 22 were diagnosed with active pulmonary tuberculosis with the diagnostic yield of 66.7%. Among above 22 cases, the overall positive rate of BALF diagnosis was as high as 95.6%, and the highest diagnostic rate of a single test was BALF XpertMTB/RIF, 59.1%. Compared with pathological tissues, the diagnostic positive rate of BALF as a diagnostic specimen was higher (p < .05). In addition, the diagnostic yield of EBUS-TBLB in pulmonary tuberculosis was not affected by patient's age, lesion extent size, EBUS probe position, presence or tracheal grade, or characteristics of lesions (all p > .05). Conclusion:Transbronchial radial ultrasound-guided lung biopsy of tuberculous PPLs possesses higher diagnostic rate, fewer complications and less interference, exerts potential application value in the diagnosis of tuberculous peripheral pulmonary lesions.