| 赵洁婷,李会方,叶伟,等.肺外结核80 例临床病理特征及几种常见结核分枝杆菌检测技术对比分析[J].安徽医药,2022,26(8):1532-1536. |
| 肺外结核80 例临床病理特征及几种常见结核分枝杆菌检测技术对比分析 |
| A clinicopathological analysis of 80 cases of Extra-pulmonary tuberculosisd and comparative analysis of several common mycobacterium tuberculosis detection techniques |
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| DOI：10.3969/j.issn.1009-6469.2022.08.011 |
| 中文关键词: 肺外结核 临床病理特征 福尔马林固定-石蜡包埋标本 结核荧光PCR |
| 英文关键词: Extra-pulmonary tuberculosis Clinicopathological characteristics FFPE specimen PCR-fluorescent probe method |
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| 中文摘要: |
| 目的探究肺外结核的临床病理特征，比较几种常见结核分枝杆菌检测技术在肺外结核诊断中的价值。方法回顾性分析2018年8月至2019年8月就诊于安徽省胸科医院经病理确诊的80例肺外结核病人的临床病理资料。结果肺外结核病人主要集中在19～84岁年龄段。80例病人中有基础疾病的8例(10.0%)，合并肺结核的45例(56.3%)。肺外结核可发生在多器官、组织，其中发生在淋巴结44例(55.0%)，鼻、咽、喉、声带、声门11例(13.8%)，骨、关节9例(11.2%)，泌尿、生殖系统8例(10.0%)，消化道4例(5.0%)，腹膜2例(2.5%)，皮肤2例(2.5%)。多数病人首发症状以局部表现为主，结核全身中毒症状少见。不同部位的肺外结核，其常见病理改变存在差异:淋巴结结核病理改变以坏死性肉芽肿常见，32/44例(72.7%)。鼻、咽、喉、声带、声门结核病理改变以渗出性病变常见，6/11例(54.6%)。骨、关节结核病理改变以坏死性肉芽肿常见，4/9例(44.4%)。泌尿、生殖系统结核病理改变以坏死性肉芽肿常见，4/8例(50.0%)。腹膜结核和皮肤结核病理改变均以坏死性肉芽肿常见(100%)。相关实验室检查中，80例福尔马林固定-石蜡包埋(FFPE)标本中结核分枝杆菌荧光PCR法的阳性率高于分枝杆菌菌种鉴定、血液T-SPOT和血清学结核抗体检测，差异有统计学意义(P<0.001)。结论肺外结核在性别、年龄分布、临床表现方面缺乏特异性，组织学病理改变结合FFPE标本结核分枝杆菌荧光PCR检测可提高诊断效率。 |
| 英文摘要: |
| Objective To explore the clinicopathological characteristics of extra-pulmonary tuberculosis and compare the value of several common mycobacterium tuberculosis detection techniques in the diagnosis of extra-pulmonary tuberculosis.Methods The clinicopathological data of 80 patients with extra-pulmonary tuberculosis diagnosed by pathology in Anhui Chest Hospital,from August 2018 to August 2019 were analyzed retrospectively.Results The patients with extra-pulmonary tuberculosis were mainly aged from 19 to 84 years.Among the 80 patients,8 cases (10.0%) had underlying diseases and 45 cases (56.3%) had tuberculosis.Extra-pulmonary tu?berculosis can involved multiple organs and tissues, including 44 cases of lymph nodes (55.0%), 11 cases of nose, pharynx, throat, vo?cal cord and glottis (13.8%), 9 cases of bone and joint (11.2%),8 cases of urinary and reproductive system (10.0%),4 cases of digestive tract (5.0%), 2 cases of peritoneum (2.5%) and 2 cases of skin (2.5%).The first symptoms of most patients were mainly local manifesta?tions, and the symptoms of systemic poisoning of tuberculosis are rare. The main pathological changes of extra-pulmonary tuberculosis were different in different locations. The common pathological change of lymphatic tuberculosis was necrotizing granuloma,32 /44 cases(72.7%). The common pathological change of nasal, pharynx, larynx, vocal cord and glottic tuberculosis was exudative lesions,6/11 cas?es (54.6%). The common pathological change of bone and joint tuberculosis was necrotic granulomas,4/9 cases (44.4%).The common pathological change of urogenital tuberculosis was necrotic granuloma,4/8 cases (50.0%).The common pathological change of 2 cases of peritoneal tuberculosis and 2 cases of skin tuberculosis showed necrotizing granuloma (100%).In laboratory tests, 80 cases of formalinfixed-paraffin embedded (FFPE) tissue, the positive rate of PCR-fluorescent was higher than that of mycobacterium species identifica?tion, blood T-spot and serum tuberculosis antibody,the difference was significant statistically(P<0.001).Conclusions Extra-pulmo?nary tuberculosis lacks specificity in sex, age distribution and clinical manifestations.Histological pathological changes combined with fluorescent PCR detection of MTB in FFPE tissues can improve diagnostic efficiency. |
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