关键词: 结核, 肺, 病理学, 临床, 聚合酶链反应, 原位杂交, 诊断

Abstract:

Objective: To explore the clinical application value of four common in situ pathological detection techniques in the detection and diagnosis of pulmonary tuberculosis. Methods: Paraffin-embedded lung tissue samples were collected from 106 patients suspected of pulmonary tuberculosis in the Pathology Department of the North China University of Science and Technology Affiliated Hospital from January 2018 to June 2022. According to the clinical diagnostic criteria, 74 patients were diagnosed as pulmonary tuberculosis and 32 were diagnosed as non-pulmonary tuberculosis (including pulmonary sarcoidosis 10 cases, chronic non-necrotizing granulomatous inflammation 22 cases). Four common in situ pathological staining techniques (antacid staining, auramine O fluorescence staining, immunohistochemistry and in situ hybridization) and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) were used to analyze and compare the diagnostic efficacy of the four techniques in the histopathologic diagnosis of pulmonary tuberculosis. Results: Based on the clinical diagnosis results, the sensitivity, specificity and Kappa values of acid-fast bacillus staining of paraffin-embedded lung tissue samples were 35.1% (26/74), 100.0% (32/32) and 0.246, respectively. The sensitivity, specificity and Kappa values were 56.8% (42/74), 93.8% (30/32) and 0.399 of auramine O fluorescence staining, 47.3% (35/74), 100.0% (32/32) and 0.351 of immune-histochemical detection, 78.4% (58/74), 100.0% (32/32) and 0.686 of in situ hybridization, and 81.1% (60/74), 100.0% (32/32) and 0.721 of qRT-PCR, respectively. Compared with the clinical diagnosis results, among the four in situ pathological techniques, only in situ hybridization had a higher Kappa value of 0.686. Conclusion: Based on clinical diagnosis results and real-time PCR, among the four in situ pathological detection techniques, in situ hybridization has a high consistency with clinical diagnostic results, and can be used for patients with pulmonary tuberculosis that cannot be diagnosed by histopathological morphology.

Key words: Tuberculosis, pulmonary, Pathology, clinical, Polymerase chain reaction, In situ hybridization, Diagnosis