Immunohistochemical diagnosis of abdominal and lymph node tuberculosis by detecting Mycobacterium tuberculosis complex specific antigen MPT64

被引:64
作者
Purohit, Manju R. [1 ,2 ,3 ]
Mustafa, Tehmina [1 ,4 ]
Wiker, Harald G. [4 ,5 ]
Morkve, Odd [1 ,6 ]
Sviland, Lisbet [1 ,2 ]
机构
[1] Univ Bergen, Ctr Int Hlth, Bergen, Norway
[2] Haukeland Hosp, Dept Pathol, N-5021 Bergen, Norway
[3] RD Gardi Med Coll, Dept Pathol, Ujjain, Madhya Pradesh, India
[4] Univ Bergen, Gade Inst, Microbiol & Immunol Sect, Bergen, Norway
[5] Haukeland Hosp, Dept Microbiol & Immunol, N-5021 Bergen, Norway
[6] Haukeland Hosp, Dept Thorac Med, N-5021 Bergen, Norway
关键词
Human Immunodeficiency Virus; Tuberculosis; Mesenteric Lymph Node; Acid Fast Bacillus; Mycobacterial Antigen;
D O I
10.1186/1746-1596-2-36
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Background: The aim of this study was to evaluate the diagnostic potential of immunohistochemistry using an antibody to the secreted mycobacterial antigen MPT64, in abdominal and lymph node tuberculosis. Methods: We used formalin-fixed histologically diagnosed abdominal tuberculosis (n = 33) and cervical tuberculous lymphadenitis (n = 120) biopsies. These were investigated using a combination of Ziehl-Neelsen method, culture, immunohistochemistry with an antibody to MPT64, a specific antigen for Mycobacterium tuberculosis complex organisms. Abdominal and cervical lymph node biopsies from non-mycobacterial diseases (n = 50) were similarly tested as negative controls. Immunohistochemistry with commercially available anti-BCG and nested PCR for IS6110 were done for comparison. Nested PCR was positive in 86.3% cases and the results of all the tests were compared using nested PCR as the gold standard. Results: In lymph node biopsies, immunohistochemistry with anti-MPT64 was positive in 96 (80%) cases and 4 (12.5%) controls and with anti-BCG 92 (76.6%), and 9 (28%) respectively. The results for cases and controls in abdominal biopsies were 25 (75.7%) and 2 (11.1%) for anti-MPT64 and 25 (75.7%) and 4 (22%) for anti-BCG. The overall sensitivity, specificity, positive and negative predictive values of immunohistochemistry with anti-MPT64 was 92%, 97%, 98%, and 85%, respectively while the corresponding values for anti-BCG were 88%, 85%, 92%, and 78%. Conclusion: Immunohistochemistry using anti-MPT64 is a simple and sensitive technique for establishing an early and specific diagnosis of M. tuberculosis infection and one that can easily be incorporated into routine histopathology laboratories.
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页数:9
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