巢式PCR、原位杂交、免疫组化技术在结核病诊断中的应用价值  

Applicable Values of Nested-PCR,Hybridization in situ and Immunohistochemistry Techniques in Diagnosis of Tuberculosis

作　　者：陈泽慧[1] 刘华庆[2] 肖庆帮[2] 杨琪[3] 郑洪[2] 

机构地区：[1]遵义医学院附属医院检验科,贵州遵义563003 [2]遵义医学院附属医院病理科,贵州遵义563003 [3]遵义医学院附属医院检验系,贵州遵义563003

出　　处：《中华医院感染学杂志》2009年第24期3442-3445,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科学技术基经项目(黔科合J字[2007]2128)

摘　　要：目的探讨巢式PCR(nPCR)、原位杂交、免疫组化技术在结核病诊断中的应用价值。方法收集病理诊断为结核的石蜡包埋组织45例,可疑结核组织60例,非结核组织30例;通过nPCR、原位杂交、免疫组化及抗酸染色法分别检测结核分枝杆菌特有的重复序列IS6110的片段、BCG抗原和抗酸杆菌。结果nPCR、免疫组化、原位杂交方法在结核组的阳性率分别为91.1%、88.9%、60.0%,在可疑结核组的阳性率分别为56.7%、53.3%、36.7%;在非结核组的阳性率分别为0、13.3%、0;各组检出率明显高于萋-尼抗酸染色法(P<0.05);nPCR与免疫组化法检测结果在各组间差异无统计学意义(P>0.05)。结论nPCR、原位杂交及免疫组化技术在结核病诊断中敏感性明显高于抗酸染色,其中nPCR阳性率最高、其余依次为免疫组化、原位杂交,这3种方法均可用于结核病与非结核病时的辅助鉴别诊断方法,尤其是对那些常规HE染色和抗酸染色无法确诊的病例更具有意义。OBJECTIVE To explore the applications values of nested-PCR（nPCR）,hybridization in situ and immunohistochemistry techniques in the diagnosis of tuberculosis.METHODS Sixty tuberculosis tissue samples,45 suspected tuberculosis tissue samples and 30 non-tuberculosis samples were collected to detect fragments of insertion sequence（IS） 6110 of Mycobacterium tuberculosis,BCG and acid-fast bacilli by using techniques of nPCR,hybridization in situ immunohistochemistry and acid-fast stain.RESULTS The positive rates of nested-PCR,hybridization in situ and immunohistochemistry techniques were 91.1%,88.9 and 60.0% in the tuberculosis group,56.7%,53.3% and 36.7% in the suspected TB group and 10.0%,13.3% and 6.7% in the non-tuberculosis group.No statistic difference was observed between the nPCR and immunohistochemistry techniques（P0.05）,but these positive rates were notable decreased comparing with nPCR and immunohistochemistry techniques（P0.05）.CONCLUSIONS The sensitivity in the techniques of nPCR,hybridization in situ and immunohistochemistry in the diagnosis of TB is significantly higher than those of Ziehl-Neelsen acid-fast stain.The positive rate of nPCR is the highest,and then are immunohistochemistry,and hybridization in situ.They all can be employed as additional differential diagnosis methods,especially in the cases which can not be distinguished with certainty from other diseases by histopathology and Ziehl-Neelsen′s staining.

关 键 词：结核 巢式PCR 免疫组织化学 原位杂交 抗酸染色 

分 类 号：R378.911[医药卫生—病原生物学]