结核病分子病理学诊断技术临床应用进展

Progress in clinical application of molecular pathological diagnosis of tuberculosis

病理学是诊断结核病的重要途径,尤其在痰菌阴性的肺结核及肺外结核等疑难患者的诊断中发挥了重要作用。2017年公布的《中国结核病病理学诊断专家共识》提出病理学确诊结核病必须同时满足两个条件：（1）组织形态学符合结核病病理基本变化;（2）通过分子病理学检测获得明确的病原学依据。近年来,分子病理学诊断技术在结核病的诊断和鉴别诊断中起到越来越重要的作用。作者对分子病理学技术在诊断结核病、非结核分枝杆菌病,以及耐药结核病中的应用进展进行了综述。

Pathology plays important roles in diagnosis of tuberculosis, especially in intractable cases such as sputum-negative pulmonary tuberculosis and extrapulmonary tuberculosis. ＂ Chinese Expert Consensus on Pathological Diagnosis of Tuberculosis＂ published in 2017 pointed out that definite pathological diagnosis of tuberculosis should meet both of the criteria： （1） basic tuberculous histological changes are found, （2） definite etiological evidences are confirmed by molecular pathology. In recent years, molecular pathological techniques play more and more important roles in the diagnosis and differential diagnosis of tuberculosis. The author reviews the progress of molecular pathological techniques in diagnosis of tuberculosis, non-tuberculous mycobacterial diseases, and drug-resistant tuberculosis.