抗酸染色与PCR-荧光探针法在石蜡包埋组织结核分枝杆菌检测的比较

The Comparison of Acid-fast Staining and PCR-fluorescence Probe Detection of Mycobacterium Tuberculosis in Paraffin-embedded Tissues

目的比较抗酸染色与PCR-荧光探针法检测在福尔马林固定、石蜡包埋组织中结核分枝杆菌(Mycobaeterium tuberculosis,MTB)检测的应用。方法收集西京医院2018年1月至2019年10月共543例疑似结核患者,所有组织标本均经10%中性福尔马林固定,常规石蜡包埋、切片,HE染色,行抗酸染色及PCR-荧光探针法检测。结果 543例疑似结核患者的石蜡包埋组织中,抗酸法检测MTB阳性58例,阳性率为10.68%,PCR-荧光探针法检测MTB阳性211例,阳性率为38.86%,两者阳性率比较差异有统计学意义(P<0.05),两种方法符合率为69.98%。其中明确临床诊断结果者187例,PCR-荧光探针法Youden指数(J=0.5245)较抗酸染色法Youden指数(J=0.2095)高。结论 PCR-荧光探针法检测石蜡包埋组织中的结核分枝杆菌,阳性检出率显著高于抗酸染色法,且诊断价值高,能够为临床提供可靠的诊断依据。

Objective The application of acid-fast staining and PCR-fluorescent probe in detection of mycobacterium tuberculosis in formalin fixed and paraffin-embedded tissues was compared.Methods A total of 543 patients with suspected tuberculosis were collected from January 2018 to October 2019 in Xijing hospital.All the tissue samples were fixed with 10% neutral formalin,embedded with paraffin,sectioned,stained with HE,acid-resistant staining and PCR-fluorescence probe detection.Results Among the paraffin-embedded tissues of 543 suspected tuberculosis patients,acid resistance method was used to detect positive MTB in 58 cases,with a positive rate of 10.68%.PCR-fluorescent probe method was used in 211 cases,with a positive rate of 38.86%.The difference in the positive rates between the two methods was statistically significant (P<0.05),and the coincidence rate of the two methods was 69.98%.Among the 187 cases with definite clinical diagnosis results,the Youden index (J=0.5245) of PCR-fluorescence probe method was higher than that of acid-fast staining method (J=0.2095).Conclusion The positive detection rate of mycobacterium tuberculosis in paraffin-embedded tissues by PCR-fluorescent probe method is significantly higher than that by acid-fast staining method,and the diagnostic value is high,which can provide a reliable basis for clinical diagnosis.