聚合酶链反应和免疫组化检测猫抓病患者淋巴结巴尔通体感染  

Evaluation of polymerase chain reaction and immunohistochemistry in identifying Bartonella Spp. in affected lymph nodes from cat scratch disease patients

作　　者：黄娟[1,2] 唐源[1] 廖殿英[1] 李甘地[1] 

机构地区：[1]四川大学华西医院病理科,成都610041 [2]西南医科大学附属医院病理科,泸州646000

出　　处：《临床与实验病理学杂志》2016年第5期548-551,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 探讨聚合酶链反应（polymerase chain reaction,PCR）和免疫组化法检测猫抓病患者巴尔通体感染情况,探讨两种方法在石蜡包埋组织中确诊猫抓病的实用价值。方法 收集94例经病理形态学诊断的猫抓病石蜡包埋淋巴结组织,分别使用针对巴尔通体柠檬酸合成酶（gltA）基因、16~23SrRNA基因的2种引物扩增巴尔通体基因序列以及使用汉赛巴尔通体单克隆抗体检测组织中巴尔通体感染情况。结果 66例（70.2%）抗汉赛巴尔通体单克隆抗体染色阳性,阳性信号主要呈点状、颗粒状,少数呈线样勾勒出细菌形状。应用PCR法检测有57例（60.6%）汉赛巴尔通体191bp长度的gltA基因;另40例（42.5%）检测出汉赛巴尔通体163bp长度的16~23SrRNA基因,无其他巴尔通体种类检测出。综合上述检测结果显示有76例（80.8%）检出汉赛巴尔通体的感染。结论 汉赛巴尔通体是我国猫抓病患者的病原体,应用PCR法和免疫组化EnVision两步法检测汉赛巴尔通体有助于确诊猫抓病,汉赛巴尔通体单克隆抗体检测是目前较为理想的检测方法。Purpose To evaluate the diagnostic utility of polymerase chain reaction （PCR） and immunohistochemistry in identifying species of Bartonella Spp. infection and pathologic diagnosis of cat scratch disease （CSD） in paraffin-embedded tissues. Methods The paraffin-embedded lymph nodes tissues of 94 histologically-defined cases of CSD were retrieved and studied using 2 different PCR assays targeted Bartonella Spp. and mouse monoelonal antibody against Bartonella henselae （Bh-mAB）. Result Immunohistochemical stain using Bh-mAB： in 66 of 94 cases （70. 2% ） dot-like, granular and few linear positive signals were observed. PCR assays： a 191-bp amplified fragment of the citrate synthase （glt A） gene by one primer pair was observed in 57 of 94 cases （60. 6% ）. Another 163-bp amplified fragment of the 16 -23S rRNA gene was only seen in 40 of 94 cases （42.5%）. Besides Bartonella henselae, no oth- er Bartonella species was observed. When applying above methods together, Bartonella henselae was observed in 76 of 94 cases （80. 8% ）. Conclusion Bartonella henselae is the causative pathogen of cat scratch disease. PCR and Bh-mAB immunostain are helpful in confirming the histological diagnosis. Using Bh-mAB can be a better alternative than PCR in identifying the organisms.

关 键 词：猫抓病 巴尔通体 免疫组织化学 聚合酶链反应 

分 类 号：R446.5[医药卫生—诊断学]