实时聚合酶链反应在肾活检标本中对早期肾结核的快速诊断。

Rapid diagnosis in early stage renal tuberculosis by real-time polymerase chain reaction on renal biopsy specimens.

机构信息

Department of Nephrology, First Affiliated Hospital of China Medical University, Shenyang, China.

出版信息

Int J Tuberc Lung Dis. 2010 Mar;14(3):341-6.

PMID:20132626

Abstract

OBJECTIVE

To determine the early rapid diagnosis of renal tuberculosis (RTB) by real-time polymerase chain reaction (PCR) on renal biopsy specimens.

METHODS

Ninety patients were selected for this study. The patients were divided into the following three groups: RTB, non-RTB (N-RTB) and clinically suspected RTB (CS-RTB). The renal biopsy specimens of these patients were used for Mycobacterium tuberculosis DNA detection by real-time PCR, using 35 and 40 as cycle threshold (C(T)) cut-off values. Morning urine samples were collected for M. tuberculosis culture.

RESULTS

In the RTB group, 25 C(T)35 and 28 C(T)40 patients were PCR-positive, seven of whom were urine M. tuberculosis culture-positive. In the N-RTB group, four C(T)35 and 13 C(T)40 patients were PCR-positive, none of whom were urine M. tuberculosis culture-positive. In the CS-RTB group, nine C(T)35 and 14 C(T)40 patients were PCR-positive, two of whom were urine M. tuberculosis culture-positive during 12 months of follow-up. The sensitivity and specificity of real-time PCR (C(T)40) were respectively 93.3% and 56.7%. The sensitivity and specificity of real-time PCR (C(T)35) were respectively 83.3% and 86.7%. The sensitivity and specificity of the urine M. tuberculosis culture were respectively 23.3% and 100%.

CONCLUSIONS

The detection of M. tuberculosis DNA in renal biopsy tissue by real-time PCR is highly sensitive. Real-time PCR can increase diagnostic accuracy and provide valuable information regarding the early diagnosis of RTB.

摘要

目的

通过实时聚合酶链反应（PCR）检测肾活检标本，确定肾结核（RTB）的早期快速诊断。

方法

本研究选择了 90 例患者。将患者分为以下三组：RTB、非 RTB（N-RTB）和临床疑似 RTB（CS-RTB）。采用实时 PCR 检测这些患者肾活检标本中的结核分枝杆菌 DNA，以 35 和 40 为循环阈值（C（T））截断值。收集晨尿进行结核分枝杆菌培养。

结果

在 RTB 组中，25 例 C（T）35 和 28 例 C（T）40 的患者 PCR 阳性，其中 7 例尿结核分枝杆菌培养阳性。在 N-RTB 组中，4 例 C（T）35 和 13 例 C（T）40 的患者 PCR 阳性，均未培养出尿结核分枝杆菌。在 CS-RTB 组中，9 例 C（T）35 和 14 例 C（T）40 的患者 PCR 阳性，其中 2 例在 12 个月的随访中尿结核分枝杆菌培养阳性。实时 PCR（C（T）40）的敏感性和特异性分别为 93.3%和 56.7%。实时 PCR（C（T）35）的敏感性和特异性分别为 83.3%和 86.7%。尿结核分枝杆菌培养的敏感性和特异性分别为 23.3%和 100%。