Clinical application of immunohistochemistry and PCR technique in pathological diagnosis of tuberculous lymphadenitis

doi:10.3969/j.issn.1000-6621.2018.04.002

Abstract

Abstract:

Objective To evaluate the clinical value of immunohistochemistry (IHC) and polymerase chain reaction (PCR) methods in pathological diagnosis of tuberculous lymphadenitis. Methods Paraffin-embedded tissue specimens from 48 patients with tuberculous lymphadenitis who had undergone radical resection (the tuberculosis (TB) group) and 21 cases with other diseases in lymph node (the non-TB group) were collected during Jan 2012 to Jul 2013 in Beijing Chest Hospital, Capital Medical University. One-step IHC using antibody targeting Ag85B, Taqman fluorescent quantitative PCR and acid-fast staining were conducted. Their diagnostic efficiency were analyzed, taking the clinical final diagnosis as golden standard.Results The IHC and PCR showed significantly higher sensitivity than that of acid-fast staining (χ ²=6.27, P=0.012; χ ²=10.84, P=0.001, respectively), by the results of 52.1% (25/48) and 60.4% (29/48) versus 27.1% (13/48). However, there was no significant difference in sensitivity between IHC and PCR (χ ²=0.68, P=0.411). The detection results of IHC, PCR and acid-fast staining in non-TB group were all negative, with a specificity of 100% (21/21) for each test. The IHC and PCR had higher negative predictive value and accordance rate than acid-fast staining (47.7% (21/44), 52.5% (21/40), 37.5% (21/56), respectively; 66.7% (46/69), 72.5% (50/69), 49.3% (34/69), respectively). Conclusion IHC and PCR methods are simple and have higher sensitivity compared to acid-fast staining method. IHC and PCR showed good clinical application value in pathological diagnosis of tuberculous lymphadenitis.

Key words: Tuberculosis,lymph node, Immunohistochemistry, Polymerase chain reaction, Pathology, Comparative study

Yu-jie DONG,Li ZHANG,Yu-xuan WANG,Li-juan ZHOU,Yang QU,Chen ZHANG,Hai-qing ZHANG,Nan-Ying CHE. Clinical application of immunohistochemistry and PCR technique in pathological diagnosis of tuberculous lymphadenitis[J]. Chinese Journal of Antituberculosis, 2018, 40(4): 348-352. doi: 10.3969/j.issn.1000-6621.2018.04.002

Figures/Tables 5

References 23

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检测方法	结核组(例)		非结核组(例)		敏感度 (%)	特异度 (%)	阳性预测值(%)	阴性预测值(%)	符合率 (%)
检测方法	阳性	阴性	阳性	阴性	敏感度 (%)	特异度 (%)	阳性预测值(%)	阴性预测值(%)	符合率 (%)
IHC染色	25	23	0	21	52.1	100.0	100.0	47.7	66.7
荧光定量PCR	29	19	0	21	60.4	100.0	100.0	52.5	72.5
抗酸染色	13	35	0	21	27.1	100.0	100.0	37.5	49.3