摘要
目的 评价淋巴结结核福尔马林固定石蜡包埋(formalin fixed paraffin embedded,FFPE)组织荧光定量聚合酶链反应(quantitative polymerase chain reaction,q-PCR)联合多方法学的诊断效能。方法 收集2023年1月至12月期间深圳市第三人民医院收治并确诊为淋巴结结核患者共计77例的临床资料,并同时进行组织q-PCR、组织结核分枝杆菌/利福平耐药检测(GeneXpert mycobacterium tuberculosis/rifampicin resistance test,GeneXpert MTB/RIF)、全血γ干扰素释放试验(interferon-gamma release assay,IGRAs)、组织抗酸染色、痰液MTB培养、组织病理苏木精-伊红(hematoxylin-eosin,HE)染色等方法的诊断阳性率比较分析。结果 在77例临床诊断为淋巴结结核患者中,组织病理HE染色诊断率为49.35%,组织q-PCR检测阳性率为75.32%,组织抗酸染色阳性率为25.97%,组织GeneXpert MTB/RIF检测阳性率为50.64%,痰液MTB培养阳性为23.37%,全血IGRAs检测阳性率为71.42%,血清结核抗体MMTB-Ab检测阳性率为64.93%。组织q-PCR检测方法阳性率显著高于组织抗酸染色(χ^(2)=37.512,P<0.001);组织q-PCR与组织GeneXpert MTB/RIF(χ^(2)=10.055,P<0.001)、组织病理HE染色法(χ^(2)=11.063,P<0.001),以及组织q-PCR与痰培养法比较(χ^(2)=41.565,P<0.001)比较差异具有统计学意义。组织q-PCR、GeneXpert MTB/RIF和IGRAs方法三者联合应用时,诊断阳性率高达90.90%。结论 q-PCR检测技术联合常规方法可有效提高FFPE组织中淋巴结结核的诊断率,对肺外结核病理组织样本的快速诊断具有临床实用价值。
Objective To evaluate the diagnostic efficacy of quantitative polymerase chain reaction(q-PCR)combined with multiple methodologies in formalin fixed paraffin embedded(FFPE)tissues of tuberculous lymphadenopathy.Method A total of 77 patients with extrapulmonary lymph node tuberculosis admitted to the Third People's Hospital of Shenzhen from January to December 2023 and their clinical data were collected.At the same time,the diagnostic positive rates of q-PCR,GeneXpert mycobacterium tuberculosis/rifampicin resistance test(GeneXpert MTB/RIF),interferon-gamma release assay(IGRAs),tissue acid-fast staining,sputum mycobacterium tuberculosis culture and HE staining were compared and analyzed.Result In 77 patients with clinical diagnosis of lymph node tuberculosis,the diagnostic rate of histopathological HE staining was 49.35%,the positive rate of tissue q-PCR was 75.32%,the positive rate of tissue acid-fast staining was 25.97%,the positive rate of tissue GeneXpert MTB/RIF was 50.64%,the positive rate of sputum Mycobacterium tuberculosis culture was 23.37%,the positive rate of whole blood IGRAs was 71.42%,and the positive rate of serum tuberculosis antibody MMTB-Ab was 64.93%.Tissue q-PCR detection method was significantly higher than tissue acid-fast staining(χ^(2)=37.512,P<0.001),tissue q-PCR was compared with tissue GeneXpert MTB/RIF method(χ^(2)=10.055,P<0.001),tissue q-PCR was compared with tissue HE staining method(χ^(2)=11.063,P<0.001),and tissue q-PCR was compared with sputum culture method(χ^(2)=41.565,P<0.001).The comparison between groups was statistically significant.When q-PCR,GeneXpert MTB/RIF and IGRAs were used in combination,the diagnostic positive rate was as high as 90.90%.Conclusion The combination of q-PCR and routine methods can effectively improve the diagnostic rate of tuberculous lymphadenopathy in FFPE tissues,and has clinical practical significance for the rapid diagnosis of extrapulmonary tuberculosis.
作者
张雅曦
杨倩婷
张洁云
张明霞
熊欣雨
陈骑
Zhang Yaxi;Yang Qianting;Zhang Jieyun;Zhang Mingxia;Xiong Xinyu;Chen Qi(Institute of Hepatology,Shenzhen Third People's Hospital,Guangdong Shenzhen 518112,China)
出处
《新发传染病电子杂志》
2025年第1期8-11,共4页
Electronic Journal of Emerging Infectious Diseases
基金
国家自然科学基金面上项目(82172286)
深圳市科技计划基础研究面上项目(JCYJ20210324131603008)。
关键词
淋巴结结核
组织荧光定量聚合酶链反应
病理诊断
Lymph node tuberculosis
Tissue quantitative polymerase chain reaction
Pathological diagnosis
