Multiplex polymerase chain reaction using insertion sequence 6110 (IS6110) and mycobacterial protein fraction from BCG of Rm 0.64 in electrophoresis target genes for diagnosis of tuberculous lymphadenitis
Multiplex polymerase chain reaction using insertion sequence 6110 (IS6110) and mycobacterial protein fraction from BCG of Rm 0.64 in electrophoresis target genes for diagnosis of tuberculous lymphadenitis
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DOI：
10.4103/0255-0857.108714
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发表时间：
2013-01-01
影响因子：
1.6
通讯作者：
Sharma, M.
中科院分区：
文献类型：
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作者：
Sharma, K.;Gupta, N.;Sharma, M.
目的：结核性淋巴结炎（TBLA）是肺外结核（EPTB）的常见表现，约占病例的30-40%。及时诊断和及时开始抗结核治疗（ATT）是成功临床结果的关键。本研究采用MPB64和IS6110对多重聚合酶链反应（multiple polymerase chain reaction， MPCR）进行评价，并与传统的TBLA快速诊断方法进行比较。材料与方法：在我们的研究中，对患者的淋巴结细针抽吸进行了评估。TBLA。第1组：TBLA组，分为(a)确诊TBLA病例（n = 80）：培养/涂片阳性或细胞学检查显示存在上皮样细胞肉芽肿，伴或不伴多核巨细胞和干酪样坏死，伴有AFB； (b)疑似TBLA病例（n = 30）：培养/涂片阴性和细胞学检查显示存在上皮样细胞肉芽肿，并对ATT有反应；第二组（对照组）（n = 25）：确诊为结节病、淋巴瘤等其他疾病引起的淋巴结病变，所有标本均行常规检查及MPCR检查。对于MPCR，我们使用了结核分枝杆菌特异性的MPB64和IS6110区域的脱氧核糖核酸序列。结果：确诊TBLA组Ziehl-Neelsen （ZN）涂片、细胞学、培养、MPCR阳性率分别为30%、70%、26.3%、91.3%。疑似TBLA组涂片、培养阴性，细胞学和MPCR敏感性分别为73.3%和86.6%。在对照组中，所有检测结果均为阴性，因此本研究中所有检测结果的特异性为100%。结论：高灵敏度、高特异性的MPCR等技术可在TBLA的快速诊断中发挥重要作用。
Purpose: Tubercular lymphadenitis (TBLA) is a common manifestations of extrapulmonary tuberculosis (EPTB) accounting for 30-40% of cases. Prompt diagnosis and timely initiation of anti-tubercular therapy (ATT) is the key for successful clinical outcome. This study was carried out to evaluate multiplex polymerase chain reaction (MPCR) using MPB64 and IS6110, and compare with the conventional methods for rapid diagnosis of TBLA. Materials and Methods: In our study, lymph node fine-needle aspirates of patients were evaluated for. TBLA. They were classified as Group I: TBLA group, divided into (a) Confirmed TBLA cases (n = 80): Culture/smear-positive or cytological examination showing presence of epithelioid cell granuloma with or without multinucleate giant cell and caseation necrosis with presence of AFB, and (b) suspected TBLA cases (n = 30): Culture/ smear-negative and cytological examination showing presence of epithelioid cell granuloma and response to ATT and Group II (Control) (n = 25): Patients of lymphadenopathy confirmed to be caused by other diseases such as sarcoidosis, lymphoma, etc., All samples were subjected to conventional tests and MPCR. For MPCR we used Mycobacterium tuberculosis-specific deoxyribonucleic acid sequences specific for the MPB64 and IS6110 region. Results: In the confirmed TBLA group, Ziehl-Neelsen (ZN) smear, cytology, culture, and MPCR positivity was 30%, 70%, 26.3%, and 91.3% respectively. In the suspected TBLA group, smear and culture were negative, and sensitivity of cytology and MPCR was 73.3% and 86.6%, respectively. In the control group all tests were found to be negative, thus giving a specificity of 100% to all the tests in the study. Conclusion: In conclusion, techniques like MPCR with high sensitivity and specificity can play an important role in rapid diagnosis of TBLA.