| 童海涛,郑叶,周静,等.早期分泌抗原靶标 6免疫组织化学联合抗酸染色法检测在结核病病理诊断中的价值[J].安徽医药,2026,30(1):160-164. |
| 早期分泌抗原靶标 6免疫组织化学联合抗酸染色法检测在结核病病理诊断中的价值 |
| The value of combined use of early secretory antigen target 6 immunohistochemistry and acid-fast staining in the pathological diagnosis of tuberculosis |
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| DOI：10.3969/j.issn.1009-6469.2026.01.032 |
| 中文关键词: 结核病 病理诊断 免疫组织化学 早期分泌抗原靶标 6(ESAT-6) 抗酸染色 实时荧光定量 PCR |
| 英文关键词: Tuberculosis Pathologic diagnosis Immunohistochemistry Early secreted antigenic target 6 (ESAT-6) Acid-fast staining Real time fluorogenic quantitative PCR |
| 基金项目:上海市“科技创新行动计划”医学创新研究领域项目( 22Y11920500) |
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| 中文摘要: |
| 目的探讨早期分泌抗原靶标 6(early secreted antigenic target 6，ESAT-6)联合抗酸染色检测在结核病病理诊断中的意义。方法收集 2017年 1—8月上海市公共卫生临床中心病理学诊断结核病的病人 81例临床资料，评价 ESAT-6免疫组织化学法、抗酸染色法、实时荧光定量 PCR(quantitative Real-time PCR，qRT-PCR)法检测对结核病的诊断效能，分析不同方法检测的一致性关系，并以 qRT-PCR法为标准衡量 ESAT-6免疫组织化学联合抗酸染色法检测的效果。结果 3种检测方法按结核杆菌检出率从高到低分别为 qRT-PCR法( 87.65%，71/81)、抗酸染色法( 72.84%，59/81)、 ESAT-6免疫组织化学法( 64.20%，52/ 81)(χ2=12.13，P=0.002)。 3种方法在不同病变组织的结核杆菌检出率差异无统计学意义( χ2=7.53、4.94、5.92，P=0.110、0.294、 0.210)。 ESAT-6免疫组织化学法与抗酸染色法检出率差异无统计学意义( χ2=1.40，P=0.236)3种方法总检出率为 93.83%，qRT-PCR法检出率显著高于 ESAT-6免疫组织化学法与抗酸染色法( χ2=12.19，P=0.001；χ2=5.61，P，=0.018)。抗酸染色和免疫组织化学法联合检测检出率( 85.19%，69/81)稍低于单独使用 qRT-PCR检测检出率( 87.65%，71/81)差异无统计学意义( χ2=0.21，P=0.647)。 64例样本 ESAT-6免疫组织化学联合抗酸染色法检测与 qRT-PCR检测均为阳性， 本 ESAT-6免疫组织化5例样，学联合抗酸染色法检测与 qRT-PCR检测均为阴性，检出一致性为 93.82%(Kappa=0.37，P=0.028)。结论 ESAT-6免疫组织化学联合抗酸染色法检测在结核病病理诊断中有较高价值。 |
| 英文摘要: |
| Objective To investigate the significance of Early Secreted Antigenic Target 6 (ESAT-6) combined with acid-fast stain-ing in the pathological diagnosis of tuberculosis.Methods Clinical data of 81 patients diagnosed with tuberculosis by pathology atShanghai Public Health Clinical Center from January to August 2017 and meeting the inclusion criteria were collected. The diagnos-tic efficacy of ESAT-6 immunohistochemistry, acid-fast staining, and Quantitative Real-time PCR (qRT-PCR) in detecting tuberculo-sis was evaluated. The consistency relationship between different detection methods was analyzed, and the efficacy of ESAT-6 immu-nohistochemistry combined with acid-fast staining was measured using qRT-PCR as the standard.Results The positive rates of the three detection methods for tuberculosis were ranked from high to low as follows: qRT-PCR (87.65%, 71/81), acid-fast staining (72.84%, 59/81), and ESAT-6 immunohistochemistry (64.20%, 52/81) (χ2=12.13, P=0.0023). There was no significant difference in the detection rates among different lesion sites (χ2=7.53, 4.94,5.92; P=0.110, 0.294, 0.210). There was no significant difference in the overall detection rates between ESAT-6 immunohistochemistry and acid-fast staining (χ2=1.40, P=0.236), and the overall detec-tion rate of qRT-PCR was significantly higher than that of ESAT-6 immunohistochemistry and acid-fast staining (χ2=12.19, P= 0.001; χ2=5.61, P=0.018). The detection rate of combined acid-fast staining and immunohistochemistry (85.19%, 69/81) was slightly lower than that of qRT-PCR alone (87.65%, 71/81), with no statistically significant difference (χ2=0.21, P=0.647). Among the 64 samples, ESAT-6 immunohistochemistry combined with acid-fast staining and qRT-PCR were both positive, and among the 5 sam-ples, ESAT-6 immunohistochemistry combined with acid-fast staining and qRT-PCR were both negative, with a consistency of 93.82% (Kappa=0.37, P=0.028).Conclusion ESAT-6 immunohistochemistry combined with acid-fast staining has high value in the pathological diagnosis of tuberculosis. |
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