新发传染病电子杂志2025，Vol.10Issue(1)：8-11,4.DOI:10.19871/j.cnki.xfcrbzz.2025.01.002
组织荧光定量聚合酶链反应联合多方法学在淋巴结结核诊断中的临床应用
Clinical application of tissue q-PCR combined with multiple methodologies in the diagnosis of lymph node tuberculosis
摘要
Abstract
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(χ2=37.512,P＜0.001),tissue q-PCR was compared with tissue GeneXpert MTB/RIF method(χ2=10.055,P＜0.001),tissue q-PCR was compared with tissue HE staining method(χ2=11.063,P＜0.001),and tissue q-PCR was compared with sputum culture method(χ2=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.关键词
淋巴结结核/组织荧光定量聚合酶链反应/病理诊断Key words
Lymph node tuberculosis/Tissue quantitative polymerase chain reaction/Pathological diagnosis分类
医药卫生引用本文复制引用
张雅曦,杨倩婷,张洁云,张明霞,熊欣雨,陈骑..组织荧光定量聚合酶链反应联合多方法学在淋巴结结核诊断中的临床应用[J].新发传染病电子杂志,2025,10(1):8-11,4.基金项目
1.国家自然科学基金面上项目(82172286) （82172286）
2.深圳市科技计划基础研究面上项目(JCYJ20210324131603008) （JCYJ20210324131603008）
