Job C K, Jayakumar J, Williams D L, Gillis T P
Department of Leprosy, St. Thomas Hospital and Leprosy Center, T.S. District, Tamil Nadu, India.
Int J Lepr Other Mycobact Dis. 1997 Dec;65(4):461-4.
For 39 patients suspected of early leprosy, skin biopsies of the lesions were done and bisected. One piece was used for histopathologic examination and the other for polymerase chain reaction (PCR) studies to detect Mycobacterium leprae. The diagnosis of early leprosy was made clinically in 14 patients and by histopathologic study in 26 patients. Acid-fast bacilli were seen in the histopathologic sections of only two patients, and M. leprae were detected using PCR techniques in 11 patients. In one patient the diagnosis of leprosy was made only because of the detection of M. leprae in the PCR study. Since even in endemic countries the profile of leprosy is changing, detection of leprosy lesions in their early stages has become increasingly important. Since the finding of M. leprae is crucial in the confirmatory diagnosis of early leprosy, it is suggested that PCR studies to detect M. leprae be done wherever possible in conjunction with histopathologic examination. It is also recommended that the feasibility and the cost-effectiveness of both of these methods to find M. leprae be evaluated.
对于39例疑似早期麻风病的患者，对其皮损进行了皮肤活检并将标本一分为二。其中一块用于组织病理学检查，另一块用于聚合酶链反应（PCR）研究以检测麻风分枝杆菌。14例患者通过临床诊断为早期麻风病，26例患者通过组织病理学研究确诊。仅在两名患者的组织病理学切片中发现抗酸杆菌，11例患者使用PCR技术检测到麻风分枝杆菌。在一名患者中，仅因为在PCR研究中检测到麻风分枝杆菌而确诊为麻风病。由于即使在麻风病流行国家，麻风病的情况也在发生变化，早期发现麻风病皮损变得越来越重要。由于麻风分枝杆菌的检测在早期麻风病的确证诊断中至关重要，建议尽可能结合组织病理学检查进行检测麻风分枝杆菌的PCR研究。还建议评估这两种检测麻风分枝杆菌方法的可行性和成本效益。
