荧光定量PCR和FISH技术诊断肺结核的价值比较

THE VALUES OF FLUORESCENT QUANTITATIVE PCR AND FISH DETECTION IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS

目的比较荧光定量PCR和FISH技术对肺结核诊断的敏感性和特异性。方法共收集300例明确诊断为肺结核的患者作为阳性对照组,以及收集300例健康志愿者(明确排除肺结核患者)做为阴性对照组。收集800例新收临床疑似肺结核患者做为研究组。收集该800例患者的肺活检标本以及同期的痰液标本,其中痰液进行涂片、结核杆菌分离培养以及结核杆菌DNA荧光定量PCR检测和FISH检测。比较荧光定量PCR和FISH技术对肺结核诊断阳性符合率和阴性符合率。结果 1FISH技术检测结核杆菌阳性符合率为99.3%;荧光定量PCR检测结核杆菌阳性符合率为97.3%。两者阳性符合率存在统计学差别(p=0.015)。2FISH技术检测结核杆菌阴性符合率为98.2%,荧光定量PCR技术检测结核杆菌阴性符合率为96.9%。两者阴性符合率存在统计学差别(p=0.007)。结论与荧光定量PCR比较,FISH对肺结核诊断具有较高的阳性符合率和阴性符合率。

Objective To compare the sensitivity and specificity of fluorescent quantitative PCR and FISH in the diagnosis of pulmonary tuberculosis. Methods 300 patients diagnosed with pulmonary tuberculosis were assigned into positive control group,while another 300 subjects with rule- out pulmonary tuberculosis were set as negative control group. 800 subjects suspected of pulmonary tuberculosis were set as research group,and their lung biopsy specimens and sputum specimens of the same period underwent sputum smear,isolated culture for mycobacterium tuberculosis,fluorescent quantitative PCR and FISH detection. The positive and negative coincident rates of fluorescent quantitative PCR and FISH in the diagnosis of pulmonary tuberculosis were compared. Results FISH and fluorescent quantitative PCR detection showed the positive coincident rates of mycobacterium tuberculosis were 99. 3% and97. 3% respectively,with significant difference（ p = 0. 015）. The negative coincident rates of mycobacterium tuberculosis of the two groups were 98. 2% and 96. 9%,respectively,with statistical difference as well（ p = 0. 007）.Conclusion Compared to fluorescent quantitative PCR,FISH detection has higher positive and negative coincident rates of pulmonary tuberculosis.