巢式聚合酶链反应在支气管内膜结核诊断的价值

Evaluation of nested polymerase chain reaction (NPCR) assay in diagnosing endobronchial tuberculosis

目的 :了解巢式聚合酶链反应 (NPCR)技术对支气管内膜结核 (EBTB)的诊断价值。方法 :应用巢式聚合酶链反应 (NPCR)对 2 2例支气管内膜活检组织进行结核分支杆菌DNA检测 ,并与病理检查、刷检涂片、支气管镜检后痰涂片结果比较。对照为 2 6例支气管肺癌患者。结果 :2 2例EBTB活检组织病理检查、刷检涂片、支气管镜检“激惹”后痰涂片及NPCR检测阳性率分别为 9%、18%、2 7%和 6 4% ,后者与前三者相比差异有显著性 (P均 <0 .0 1)。 2 2例支气管肺癌患者结核分支杆菌DNA的NPCR均阴性。结论 :巢式PCR技术有利于EBTB患者的诊断 ,尤其对胸片 (或CT)正常、痰菌阴性、支气管内膜活检组织未发现结核特异性病理变化者。

Objective: To evaluate the nested polymerase chain reaction (NPCR) technique in diagnosing endobronchial tuberculosis. Methods: NPCR method was used to detect mycobacterium tuberculosis DNA in bioptic tissue from 22 patients with endobronchial tuberculosis, and the results were compared with pathologic examination, brushing smear and sputum smear after bronchoscopy. The controls were 26 patients with lung cancer. Results: The positive rates of detecting mycobacterium tuberculosis were 9%, 18%, 27% and 64% respectively by pathologic examination, brushing smear, sputum smear after bronchoscopy and NPCR methods. Significant differences were found between NPCR and the other 3 methods (all P<0.01). No positive result for mycobacterium tuberculosis was found in 26 controls by NPCR. Conclusions: NPCR is a useful method for diagnosing patients with endobronchial tuberculosis, especially for those with normal demonstration in X-ray (or CT) chest film, negative sputum and nonspecific pathologic changes in endobronchial biopsy.