肺外结核80例临床病理特征及几种常见结核分枝杆菌检测技术对比分析  

A clinicopathological analysis of 80 cases of Extra-pulmonary tuberculosisd and comparative analysis of several common mycobacterium tuberculosis detection techniques

作　　者：赵洁婷 李会方 叶伟 宋蓉蓉 徐建平 ZHAO Jieting;LI Huifang;YE Wei;SONG Rongrong;XU Jianping(Department of Pathology,Anhui Chest Hospital,Hefei,Anhui 230022,China)

机构地区：[1]安徽省胸科医院病理科,安徽合肥230022

出　　处：《安徽医药》2022年第8期1532-1536,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究肺外结核的临床病理特征,比较几种常见结核分枝杆菌检测技术在肺外结核诊断中的价值。方法回顾性分析2018年8月至2019年8月就诊于安徽省胸科医院经病理确诊的80例肺外结核病人的临床病理资料。结果肺外结核病人主要集中在19~84岁年龄段。80例病人中有基础疾病的8例(10.0%),合并肺结核的45例(56.3%)。肺外结核可发生在多器官、组织,其中发生在淋巴结44例(55.0%),鼻、咽、喉、声带、声门11例(13.8%),骨、关节9例(11.2%),泌尿、生殖系统8例(10.0%),消化道4例(5.0%),腹膜2例(2.5%),皮肤2例(2.5%)。多数病人首发症状以局部表现为主,结核全身中毒症状少见。不同部位的肺外结核,其常见病理改变存在差异:淋巴结结核病理改变以坏死性肉芽肿常见,32/44例(72.7%)。鼻、咽、喉、声带、声门结核病理改变以渗出性病变常见,6/11例(54.6%)。骨、关节结核病理改变以坏死性肉芽肿常见,4/9例(44.4%)。泌尿、生殖系统结核病理改变以坏死性肉芽肿常见,4/8例(50.0%)。腹膜结核和皮肤结核病理改变均以坏死性肉芽肿常见(100%)。相关实验室检查中,80例福尔马林固定-石蜡包埋(FFPE)标本中结核分枝杆菌荧光PCR法的阳性率高于分枝杆菌菌种鉴定、血液T-SPOT和血清学结核抗体检测,差异有统计学意义(P<0.001)。结论肺外结核在性别、年龄分布、临床表现方面缺乏特异性,组织学病理改变结合FFPE标本结核分枝杆菌荧光PCR检测可提高诊断效率。Objective To explore the clinicopathological characteristics of extra-pulmonary tuberculosis and compare the value of several common mycobacterium tuberculosis detection techniques in the diagnosis of extra-pulmonary tuberculosis.Methods The clinicopathological data of 80 patients with extra-pulmonary tuberculosis diagnosed by pathology in Anhui Chest Hospital,from August 2018 to August 2019 were analyzed retrospectively.Results The patients with extra-pulmonary tuberculosis were mainly aged from 19 to 84 years.Among the 80 patients,8 cases(10.0%)had underlying diseases and 45 cases(56.3%)had tuberculosis.Extra-pulmonary tuberculosis can involved multiple organs and tissues,including 44 cases of lymph nodes(55.0%),11 cases of nose,pharynx,throat,vocal cord and glottis(13.8%),9 cases of bone and joint(11.2%),8 cases of urinary and reproductive system(10.0%),4 cases of digestive tract(5.0%),2 cases of peritoneum(2.5%)and 2 cases of skin(2.5%).The first symptoms of most patients were mainly local manifestations,and the symptoms of systemic poisoning of tuberculosis are rare.The main pathological changes of extra-pulmonary tuberculosis were different in different locations.The common pathological change of lymphatic tuberculosis was necrotizing granuloma,32/44 cases(72.7%).The common pathological change of nasal,pharynx,larynx,vocal cord and glottic tuberculosis was exudative lesions,6/11 cases(54.6%).The common pathological change of bone and joint tuberculosis was necrotic granulomas,4/9 cases(44.4%).The common pathological change of urogenital tuberculosis was necrotic granuloma,4/8 cases(50.0%).The common pathological change of 2 cases of peritoneal tuberculosis and 2 cases of skin tuberculosis showed necrotizing granuloma(100%).In laboratory tests,80 cases of formalinfixed-paraffin embedded(FFPE)tissue,the positive rate of PCR-fluorescent was higher than that of mycobacterium species identification,blood T-spot and serum tuberculosis antibody,the difference was significant statistically(P<0.001).Conclusions Extr

关 键 词：肺外结核 临床病理特征 福尔马林固定-石蜡包埋标本 结核荧光PCR 

分 类 号：R521[医药卫生—内科学]