Clinical application of tissue q-PCR combined with multiple methodologies in the diagnosis of lymph node tuberculosis

doi:10.19871/j.cnki.xfcrbzz.2025.01.002

Abstract

Abstract: Objective To evaluate the diagnostic efficacy of quantitative polymerase chain reaction (q-PCR) combined with multiple methodologies in formalin fixed paraffin embedded (FFPE) tissues of tuberculous lymphadenopathy. Method A total of 77 patients with extrapulmonary lymph node tuberculosis admitted to the Third People's Hospital of Shenzhen from January to December 2023 and their clinical data were collected. At the same time, the diagnostic positive rates of q-PCR, GeneXpert mycobacterium tuberculosis/rifampicin resistance test(GeneXpert MTB/RIF), interferon-gamma release assay(IGRAs), tissue acid-fast staining, sputum mycobacterium tuberculosis culture and HE staining were compared and analyzed. Result In 77 patients with clinical diagnosis of lymph node tuberculosis, the diagnostic rate of histopathological HE staining was 49.35%, the positive rate of tissue q-PCR was 75.32%, the positive rate of tissue acid-fast staining was 25.97%, the positive rate of tissue GeneXpert MTB/RIF was 50.64%, the positive rate of sputum Mycobacterium tuberculosis culture was 23.37%, the positive rate of whole blood IGRAs was 71.42%, and the positive rate of serum tuberculosis antibody MMTB-Ab was 64.93%. Tissue q-PCR detection method was significantly higher than tissue acid-fast staining (χ ²= 37.512, P<0.001), tissue q-PCR was compared with tissue GeneXpert MTB/RIF method (χ ²=10.055, P<0.001), tissue q-PCR was compared with tissue HE staining method (χ ²=11.063, P<0.001), and tissue q-PCR was compared with sputum culture method (χ ²=41.565, P<0.001). The comparison between groups was statistically significant. When q-PCR, GeneXpert MTB/RIF and IGRAs were used in combination, the diagnostic positive rate was as high as 90.90%. Conclusion The combination of q-PCR and routine methods can effectively improve the diagnostic rate of tuberculous lymphadenopathy in FFPE tissues, and has clinical practical significance for the rapid diagnosis of extrapulmonary tuberculosis.

Key words: Lymph node tuberculosis, Tissue quantitative polymerase chain reaction, Pathological diagnosis

CLC Number:

R446.8

Zhang Yaxi, Yang Qianting, Zhang Jieyun, Zhang Mingxia, Xiong Xinyu, Chen Qi. Clinical application of tissue q-PCR combined with multiple methodologies in the diagnosis of lymph node tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(1): 8-11.

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