| 范正超,尹航,刘建震,等.荧光定量聚合酶链反应联合抗酸染色在肾结核组织病理诊断中的应用[J].安徽医药,2022,26(5):933-937. |
| 荧光定量聚合酶链反应联合抗酸染色在肾结核组织病理诊断中的应用 |
| Clinical application value of fluorescent quantitative polymerase chain reaction technique combined with acid-fast staining in histological pathological diagnosis of tuberculous kidneys |
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| DOI：10.3969/j.issn.1009-6469.2022.05.020 |
| 中文关键词: 结核，肾 荧光定量聚合酶链反应 抗酸染色 病理诊断 |
| 英文关键词: Tuberculosis, renal Fluorescent quantitative polymerase chain reaction Acid-fast staining Pathological diagnosis |
| 基金项目:河北省医学科学研究重点课题(20170412) |
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| 中文摘要: |
| 目的探讨荧光定量聚合酶链反应(PCR)联合抗酸染色在肾结核组织病理诊断中的应用价值。方法回顾性收集2013年6月至2019年6月河北省胸科医院通过后腹腔镜技术或开放技术行肾切除术后肾病组织标本65例，其中肾结核病30例(阳性组)，非结核肾病35例(阴性组)。采用Taqman探针法荧光定量PCR技术和抗酸染色技术检测每个石蜡标本的结核杆菌病原体。采用单独和联合统计比较两种检测方法的灵敏度、特异度、阳性预测值、阴性预测值和准确性。结果抗酸染色在肾结核组织标本中的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别是53.3%、94.3%、88.9%、70.2%和75.4%；荧光定量PCR的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别是83.3%、97.1%、96.2%、87.2%和90.8%；荧光定量PCR的灵敏度较抗酸染色的灵敏度提高了30.0%，差异有统计学意义(χ2=6.24，P=0.012)。荧光定量PCR检测的准确性也高于抗酸染色检测的准确性，两者比较差异有统计学意义(χ2=5.47，P=0.019)。抗酸染色和荧光定量PCR联合检测的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别是96.7%、94.3%、93.5%、97.1%和95.4%。联合检测的灵敏度、阴性预测值、准确性均明显高于抗酸染色、荧光定量PCR的单独检测值，差异有统计学意义(P<0.05)，联合检测的特异度、阳性预测值低于荧光定量PCR单独检测值，但差异无统计学意义(P>0.05)。结论荧光定量聚合酶链反应联合抗酸染色可提高肾结核组织标本病原体检测的灵敏度、阴性预测值和准确性，在肾结核的病理诊断中具有良好的应用价值。 |
| 英文摘要: |
| Objective To investigate the clinical application value of fluorescent quantitative polymerase chain reaction (PCR) tech?nique combined with acid-fast staining in histological pathological diagnosis of tuberculous kidneys.Methods Sixty-five paraffin-em?bedded specimens of Retroperitoneoscopic or open surgery nephrectomy in Hebei Chest Hospital from June 2013 to June 2019 were ret?rospectively analyzed, 30 tuberculous kidney specimens (positive group) and 35 specimens (negative group) of other renal diseases. My?cobacterium tuberculosis in every paraffin-embedded specimen was tested by using TaqMan-probe fluorescent quantitative PCR tech?nique and acid-fast staining. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnos?tic accuracy of fluorescent quantitative PCR and acid-fast staining were calculated separately and in combination.Results The sensi?tivity, specificity,PPV,NPV and diagnostic accuracy of acid-fast staining for tuberculous kidneys were 53.3%, 94.3%, 88.9%, 70.2%and 75.4%, respectively.The sensitivity, specificity, PPV, NPV and diagnostic accuracy of fluorescent quantitative PCR were 83.3%,97.1%, 96.2%, 87.2% and 90.8%,respectively. The sensitivity of fluorescent quantitative PCR was higher by 30.0% than that of acidfast staining, and there was significant difference between them (χ2=6.64,P=0.012).The accuracy of fluorescent quantitative PCR was higher than that of acid-fast staining, and there was significant difference between them (χ2=5.47, P=0.019).Parallel testing of acid-fast staining and fluorescent quantitative PCR showed the sensitivity, specificity, PPV, NPV, and accuracy to be 96.7%, 94.3%%, 93.5%,97.1% and 95.4%, respectively. The sensitivity, NPV and accuracy of acid-fast staining and fluorescent quantitative PCR parallel test?ing were higher than that of acid-fast staining, fluorescent quantitative PCR separately, and there was significant difference between them (P<0.05). The specificity and PPV of acid-fast staining and fluorescent quantitative PCR parallel testing were lower than that of fluorescent quantitative PCR separately, but there was no significant difference between them (P>0.05).Conclusion Fluorescent quantitative PCR combined with acid-staining can improve the sensitivity, NPV and accuracy of pathogen detection in renal tuberculo?sis tissue samples, and has a good clinical application value in histological pathological diagnosis of tuberculous kidneys. |
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