Moure Zaira, Castellví Josep, Sánchez-Montalvá Adrián, Pumarola Tomás, Tórtola M Teresa
Microbiology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Research Institute (VHIR).
Pathology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Appl Immunohistochem Mol Morphol. 2019 Jan;27(1):77-80. doi: 10.1097/PAI.0000000000000533.
Extrapulmonary tuberculosis (EPTB) is increasingly frequent in developed countries. When it is not clinically suspected, samples are not collected for culture and the only material available is a tissue paraffin block.
The aim of this study was to evaluate FluoroType MTB (FT-MTB) and GenoType MTBDRplus methods for the detection of Mycobaterium tuberculosis complex in paraffin-embedded biopsies comparing the results to tuberculosis diagnosis.
A total of 17 paraffin-embedded tissues from different locations revealing granulomas were referred to the Mycobacteriology Laboratory and FT-MTB and GenoType MTBDRplus methods were performed. EPTB diagnosis was reached based on histologically compatible lesions, response to treatment and absence of alternative diagnosis. This case definition was considered gold standard for the assessment of the 2 molecular techniques performance.
Of the 17 individuals included in the study, 10 were clinically classified as EPTB and in 7 cases tuberculosis was ruled out. Of the 10 patients classified as EPTB, 6 (60%) obtained both FT-MTB and MTBDRplus positive results. Sensitivity and specificity were 60% and 71.4%, and 60% and 85.7% for FT-MTB and MTBDRplus, respectively.
Molecular techniques might be useful tools for detection of Mycobaterium tuberculosis complex in paraffin-embedded biopsies especially when there is no sample available for culture.
肺外结核(EPTB)在发达国家日益常见。当临床上未怀疑此病时,不会采集样本进行培养,唯一可获得的材料是组织石蜡块。
本研究旨在评估FluoroType MTB(FT-MTB)和GenoType MTBDRplus方法在石蜡包埋活检组织中检测结核分枝杆菌复合群的效果,并将结果与结核病诊断进行比较。
共17份来自不同部位显示肉芽肿的石蜡包埋组织被送至分枝杆菌实验室,采用FT-MTB和GenoType MTBDRplus方法进行检测。根据组织学上相符的病变、对治疗的反应以及排除其他诊断来做出EPTB诊断。该病例定义被视为评估这两种分子技术性能的金标准。
在纳入研究的17例个体中,10例临床诊断为EPTB,7例排除结核病。在诊断为EPTB的10例患者中,6例(60%)FT-MTB和MTBDRplus检测结果均为阳性。FT-MTB的敏感性和特异性分别为60%和71.4%,MTBDRplus的敏感性和特异性分别为60%和85.7%。
分子技术可能是检测石蜡包埋活检组织中结核分枝杆菌复合群的有用工具,尤其是在没有可供培养的样本时。