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聚合酶链反应在组织病理学诊断不明确的福尔马林固定石蜡包埋皮肤活检样本中对疑似皮肤利什曼病的诊断效用:来自哥伦比亚的一项初步研究

The Diagnostic Utility of PCR in FFPE Skin Biopsies with Inconclusive Histopathology for Suspected Cutaneous Leishmaniasis: A Pilot Study from Colombia.

作者信息

Mantilla Julio César, Bueno Nathalia Andrea, Alvarez Juan Pablo, López Maria Paula, Díaz Martha Lucía

机构信息

Structural, Functional and Clinical Pathology Group (PAT-UIS), Pathology Department, School of Medicine, Universidad Industrial de Santander, Bucaramanga 680002, Colombia.

Immunology and Molecular Epidemiology Group (GIEM), School of Microbiology, Universidad Industrial de Santander, Bucaramanga 680002, Colombia.

出版信息

Trop Med Infect Dis. 2025 Aug 18;10(8):232. doi: 10.3390/tropicalmed10080232.


DOI:10.3390/tropicalmed10080232
PMID:40864135
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12390503/
Abstract

UNLABELLED: Cutaneous Leishmaniasis (CL) is a tropical disease endemic in many regions of Latin America. Its clinical diagnosis is often supported by histopathological analysis of skin biopsies; however, parasite detection by microscopy can be challenging, particularly in chronic or pauciparasitic lesions, leading to inconclusive results. OBJECTIVE: This study aimed to evaluate the utility of polymerase chain reaction (PCR) as a confirmatory diagnostic tool for CL in formalin-fixed, paraffin-embedded (FFPE) biopsies with inconclusive histopathology. METHODS: We analyzed 16 FFPE skin biopsy samples from patients with clinical suspicion of CL. All cases underwent routine histopathological evaluation using hematoxylin and eosin staining and were classified as inconclusive. DNA was extracted and PCR was performed, targeting the ITS1 and miniexon regions of spp. RESULTS: PCR successfully amplified DNA in 8 (50%) out of 16 samples when both targets were utilized, confirming infection. These findings highlight the additional benefits of molecular tools in cases with inconclusive histopathology, thereby enhancing diagnostic accuracy and enabling species-level identification in certain instances. CONCLUSIONS: PCR proved to be a valuable diagnostic complement to histopathology in clinically and histologically suspected cases of CL without visible parasites. Its implementation may improve diagnostic accuracy and timely treatment in endemic areas.

摘要

未标注:皮肤利什曼病(CL)是一种在拉丁美洲许多地区流行的热带疾病。其临床诊断通常通过皮肤活检的组织病理学分析来支持;然而,通过显微镜检测寄生虫可能具有挑战性,特别是在慢性或寄生虫数量少的病变中,会导致结果不确定。 目的:本研究旨在评估聚合酶链反应(PCR)作为组织病理学结果不确定的福尔马林固定、石蜡包埋(FFPE)活检中CL的确诊诊断工具的效用。 方法:我们分析了16例临床怀疑为CL的患者的FFPE皮肤活检样本。所有病例均采用苏木精和伊红染色进行常规组织病理学评估,并被归类为结果不确定。提取DNA并进行PCR,靶向 spp.的ITS1和微小外显子区域。 结果:当使用两个靶点时,PCR成功扩增了16个样本中的8个(50%)的 DNA,证实了感染。这些发现突出了分子工具在组织病理学结果不确定的病例中的额外益处,从而提高了诊断准确性,并在某些情况下能够进行物种水平的鉴定。 结论:在临床上和组织学上怀疑为CL但无可见寄生虫的病例中,PCR被证明是组织病理学的一种有价值的诊断补充。其应用可能会提高流行地区的诊断准确性和及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/1cf6b4a3fb04/tropicalmed-10-00232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/ba934a7fd628/tropicalmed-10-00232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/c3af95e39490/tropicalmed-10-00232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/e85aac7afd06/tropicalmed-10-00232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/3d4d949dd7b9/tropicalmed-10-00232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/1cf6b4a3fb04/tropicalmed-10-00232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/ba934a7fd628/tropicalmed-10-00232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/c3af95e39490/tropicalmed-10-00232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/e85aac7afd06/tropicalmed-10-00232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/3d4d949dd7b9/tropicalmed-10-00232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e54/12390503/1cf6b4a3fb04/tropicalmed-10-00232-g005.jpg

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本文引用的文献

[1]
Diagnostic Tools for Cutaneous Leishmaniasis Caused by : A Narrative Review.

Diagnostics (Basel). 2023-9-18

[2]
Immunopathology of Cutaneous Leishmaniasis in a Cohort of Sri Lankan Patients.

Clin Pathol. 2022-11-2

[3]
Characterization of spp. Causing Cutaneous Lesions with a Negative Parasitological Diagnosis in Panama.

Trop Med Infect Dis. 2022-10-3

[4]
Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments.

Am J Clin Dermatol. 2022-11

[5]
Non-Infectious Granulomatous Dermatoses: A Pathologist's Perspective.

Indian Dermatol Online J. 2021-6-20

[6]
Leishmaniasis diagnosis: an update on the use of parasitological, immunological and molecular methods.

J Parasit Dis. 2020-6

[7]
Test accuracy of polymerase chain reaction methods against conventional diagnostic techniques for Cutaneous Leishmaniasis (CL) in patients with clinical or epidemiological suspicion of CL: Systematic review and meta-analysis.

PLoS Negl Trop Dis. 2020-1-21

[8]
Cutaneous leishmaniasis: A neglected disfiguring disease for women.

Int J Womens Dermatol. 2019-2-10

[9]
Psychosocial burden of localised cutaneous Leishmaniasis: a scoping review.

BMC Public Health. 2018-3-15

[10]
Leishmaniasis: a review.

F1000Res. 2017-5-26

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