Sun Jie, Zhou Xinchun, Yu Jiang, Fang Shiyu, Duan Shaoqi, Liu Fengjun
Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Department of Infectious Diseases, Dazhou Central Hospital, Dazhou, Sichuan, China.
J Clin Tuberc Other Mycobact Dis. 2024 Oct 19;37:100486. doi: 10.1016/j.jctube.2024.100486. eCollection 2024 Dec.
To assess the diagnostic value of tuberculosis-secreted Ag85B, ESAT-6 and CFP10 in pulmonary tuberculosis.
Immunohistochemical (IHC) and acid-fast staining were performed, the detection efficiency of the two methods were analysed with chi-square test.
Acid-fast staining demonstrated a sensitivity of (18/69, 26.09%) and a specificity of 100%. IHC staining for Ag85B, ESAT-6 and CFP10 was positive in all 18 cases with positive acid-fast staining and additionally positive in 25,36 and 30 cases, respectively, that were acid-fast-negative. The sensitivities of IHC staining for Ag85B, ESAT-6 and CFP10 were 62.32%, 78.26% and69.57%, respectively, while their specificities were 86.57%, 85.07% and 91.04%, respectively. Joint antigen analysis revealed that simultaneous positivity for two or three of Ag85B, ESAT-6 and CFP10 increased specificity (95.52% to 100%) but decreased sensitivity (49.28% to 62.31%). The presence of any one of the three antigens elevated sensitivity (81.16% to 88.41%) but lowered specificity (68.66% to 77.61%). Specificity reached 100% for concurrent positivity of all three antigens, while a sensitivity of 88.41% was observed for positivity of any one antigen.
Ag85B, ESAT-6, and CFP10 exhibits greater sensitivity in pulmonary tuberculosis and combined antigen testing enhances the diagnostic accuracy.
评估结核分泌抗原85B（Ag85B）、早期分泌性抗原靶6（ESAT-6）和培养滤液蛋白10（CFP10）在肺结核诊断中的价值。
采用免疫组织化学（IHC）和抗酸染色法，用卡方检验分析两种方法的检测效率。
抗酸染色的敏感性为（18/69，26.09%），特异性为100%。18例抗酸染色阳性病例中，Ag85B、ESAT-6和CFP10的免疫组化染色均为阳性，另外，25例、36例和30例抗酸染色阴性病例也呈阳性。Ag85B、ESAT-6和CFP10免疫组化染色的敏感性分别为62.32%、78.26%和69.57%，特异性分别为86.57%、85.07%和91.04%。联合抗原分析显示，Ag85B、ESAT-6和CFP10中两种或三种同时呈阳性可提高特异性（从95.52%提高到100%），但降低敏感性（从49.28%降低到62.31%）。三种抗原中任意一种存在可提高敏感性（从81.16%提高到88.41%），但降低特异性（从68.66%降低到77.61%）。三种抗原同时呈阳性时特异性达到100%，任意一种抗原呈阳性时敏感性为88.41%。
Ag85B、ESAT-6和CFP10在肺结核诊断中具有较高的敏感性，联合抗原检测可提高诊断准确性。
