Mohan Musi Ravindra, Sukumar Kothur Narayana-Reddy, Amith Anjaneya
Oxford Medical College Hospital and Research Center, Bangalore, Karnataka, India.
Department of Respiratory Medicine, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India.
Thorac Res Pract. 2024 May 3;25(4):158 - 161. doi: 10.5152/ThoracResPract.2024.23087.
Due to its infectious nature, complex immunological response, chronic progression, and the necessity for long-term treatment, tuberculosis has always been a major health burden. Immunohistochemistry (IHC) has the capacity to highlight the occurrence of mycobacterial antigens for tissue diagnosis. This study was conducted to understand the advantage of immunostaining over culture of Mycobacterium tuberculosis.
A cross-sectional study was conducted on 30 samples of suspected cases of tuberculosis. Specimens received were fixed in 10% formalin and processed; 3-5 µm thick sections were made from paraffin block, stained with hematoxylin and eosin, Ziehl–Neelsen stain, and immunohistochemistry. Culture was done using Lowenstein–Jensen medium. Immunohistochemistry was interpreted as fine granular brownish cytoplasmic, coarse granular brownish cytoplasmic, and bacillus staining.
Out of the 30 samples studied, 12 (40.0%) were culture positive while 20 (66.7%) of them were IHC positive. Immunohistochemistry showed 17 granulomatous lesions of which 11 (55.0%) were well-formed granulomas. The sensitivity and negative predictive value were found to be high with immunohistochemistry, while specificity and positive predictive value were found to be on the lower side. Among the 20 positive IHC cases, the degree of staining was fine granular cytoplasmic staining in 13 cases (65.0%) and coarse granular staining in 7 cases (35.0%).
Immunohistochemistry is a reliable test with high sensitivity as well as high negative predictive value which can be done rapidly for establishing an etiological diagnosis of tuberculosis in histologic specimens.
由于结核病具有传染性、复杂的免疫反应、慢性进展以及长期治疗的必要性，它一直是一项重大的健康负担。免疫组织化学（IHC）能够突出分枝杆菌抗原的存在以用于组织诊断。本研究旨在了解免疫染色相对于结核分枝杆菌培养的优势。
对30例疑似结核病病例的样本进行了横断面研究。所接收的标本用10%福尔马林固定并处理；从石蜡块制作3 - 5微米厚的切片，用苏木精和伊红染色、齐-尼氏染色以及免疫组织化学染色。使用罗-琴培养基进行培养。免疫组织化学结果解读为细颗粒棕色细胞质染色、粗颗粒棕色细胞质染色和杆菌染色。
在所研究的30个样本中，12个（40.0%）培养阳性，而其中20个（66.7%）免疫组织化学阳性。免疫组织化学显示17个肉芽肿性病变，其中11个（55.0%）为成熟肉芽肿。发现免疫组织化学的敏感性和阴性预测值较高，而特异性和阳性预测值较低。在20例免疫组织化学阳性病例中，染色程度为细颗粒细胞质染色的有13例（65.0%），粗颗粒染色的有7例（35.0%）。
免疫组织化学是一种可靠的检测方法，具有高敏感性和高阴性预测值，可快速用于在组织学标本中确立结核病的病因诊断。
