免疫组织化学染色检测肺结核组织中的Ag85B

Detection of Ag85B in pulmonary tuberculosis by immunohistochemical staining

目的:探讨结核分枝杆菌分泌性抗原Ag85B在肺结核组织中的分布特点,初步分析其在肺结核病理学诊断中的应用价值。方法:收集医院病理科手术切除的肺结核组织标本19例,以非肺结核肺组织(肺癌切除标本正常组织断端20例)为阴性对照。通过免疫组化检测Ag85B的表达情况,并与抗酸染色进行对比。结果:Ag85B免疫组化阳性信号主要沉积在结核坏死灶及周围,分布与抗酸杆菌相关、范围更广。19例肺结核标本中,10例抗酸染色阳性,抗酸染色敏感度为52.63%(10/19);10例抗酸染色阳性的标本免疫组织化学染色全部阳性,9例抗酸染色阴性的标本中免疫组化阳性的标本有6例,免疫组化敏感度为84.21%(16/19)。20例阴性对照组中,3例免疫组化呈阳性,免疫组化特异度为85.00%(17/20)。结论:Ag85B免疫组化阳性信号表达范围比抗酸杆菌分布更广,较抗酸染色具有更高的敏感性,可作为结核确诊的一种补充手段。

Objective:To investigate the distribution characteristics of Mycobacterium tuberculosis secretory antigen Ag85B in pulmonary tuberculosis tissue,and to preliminarily analyze its application value in the pathological diagnosis of pulmonary tuberculosis.Methods:19 cases of pulmonary tuberculosis tissue specimens were collected from the Department of Pathology,and 20 cases of normal lung tissue(normal tissue cut end of lung cancer resection specimen)was used as a negative control.The expression of Ag85B was detected by chemical staining and compared with acid-fast staining.Results:Ag85B immunohistochemical positive signals were mainly deposited in and around the necrotic foci of tuberculosis,and the distribution was related to acid-fast bacilli and had a wider range.Among the 19 tuberculosis samples,10 had positive acid-fast staining,and the sensitivity of acid-fast staining was 52.63%(10/19).Among the 10 samples with positive acid-fast staining,all the immunohistochemical staining was positive,and among the 9 samples with negative acid-fast staining,6 samples were immunohistochemically positive,and the immunohistochemical sensitivity was 84.21%(16/19).Among the 20 negative control tissues,3 had positive immunohistochemistry,and the immunohistochemical specificity was 85.00%(17/20).Conclusion:The expression range of Ag85B immunohistochemical positive signal is wider than that of acid-fast bacilli,and it has higher sensitivity than acid-fast staining,which may be used as a supplementary method for the diagnosis of tuberculosis.