Ghossein R A, Ross D G, Salomon R N, Rabson A R
Department of Pathology, New England Medical Center Hospital, Tufts University School of Medicine, Boston, Massachusetts.
Am J Clin Pathol. 1994 Jun;101(6):733-7. doi: 10.1093/ajcp/101.6.733.
The etiology of sarcoidosis is unknown, but mycobacteria have been considered as a possible etiologic agent. The authors used the polymerase chain reaction (PCR) to search for mycobacterial DNA in paraffin-embedded granulomatous tissues from patients with sarcoidosis. The target sequence used for PCR amplification is a 383-base pair segment of the gene encoding the 65 kD mycobacterial surface antigen. This assay can detect Mycobacterium tuberculosis and atypical mycobacteria in archival material. Its sensitivity, which is superior to Ziehl-Nielsen staining for acid-fast bacilli, is 1 bacterium per 2500 cells. Ten sarcoidosis blocks and 10 normal controls were negative with mycobacterial PCR but positive with beta-actin PCR, indicating the presence of amplifiable DNA. Mycobacterial PCR gave positive results for six acid-fast bacilli stain/culture-positive blocks from patients with tuberculosis. These results indicate that sarcoidosis probably does not represent an active mycobacterial infection. These data also suggest that mycobacterial PCR is helpful in differentiating tuberculosis and sarcoidosis.
结节病的病因尚不清楚，但分枝杆菌被认为是一种可能的致病因素。作者使用聚合酶链反应（PCR）在结节病患者石蜡包埋的肉芽肿组织中寻找分枝杆菌DNA。用于PCR扩增的靶序列是编码65kD分枝杆菌表面抗原的基因的一个383碱基对片段。该检测方法可检测存档材料中的结核分枝杆菌和非典型分枝杆菌。其灵敏度优于抗酸杆菌的萋-尼染色，为每2500个细胞中1个细菌。10个结节病组织块和10个正常对照的分枝杆菌PCR结果为阴性，但β-肌动蛋白PCR结果为阳性，表明存在可扩增DNA。结核分枝杆菌PCR对6个来自结核病患者的抗酸杆菌染色/培养阳性组织块呈阳性结果。这些结果表明，结节病可能不代表活动性分枝杆菌感染。这些数据还表明，分枝杆菌PCR有助于鉴别结核病和结节病。
