Does polymerase chain reaction of tissue specimens aid in the diagnosis of tuberculosis?

Yoo Jin Lee, Seojin Kim, Youngjin Kang, Jiyoon Jung, Eunjung Lee, Joo Young Kim, Jeong Hyeon Lee, Youngseok Lee, Yang Seok Chae, Chul Hwan Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Mycobacterial culture is the gold standard test for diagnosing tuberculosis (TB), but it is time-consuming. Polymerase chain reaction (PCR) is a highly sensitive and specific method that can reduce the time required for diagnosis. The diagnostic efficacy of PCR differs, so this study determined the actual sensitivity of TB-PCR in tissue specimens. Methods: We retrospectively reviewed 574 cases. The results of the nested PCR of the IS6110 gene, mycobacterial culture, TB-specific antigen-induced interferon-γ release assay (IGRA), acid-fast bacilli (AFB) staining, and histological findings were evaluated. Results: The positivity rates were 17.6% for PCR, 3.3% for the AFB stain, 22.2% for mycobacterial culture, and 55.4% for IGRA. PCR had a low sensitivity (51.1%) and a high specificity (86.3%) based on the culture results of other studies. The sensitivity was higher (65.5%) in cases with necrotizing granuloma but showed the highest sensitivity (66.7%) in those with necrosis only. The concordance rate between the methods indicated that PCR was the best method compared to mycobacterial culture, and the concordance rate increased for the methods using positive result for PCR or histologic features. Conclusions: PCR of tissue specimens is a good alternative to detect tuberculosis, but it may not be as sensitive as previously suggested. Its reliability may also be influenced by some histological features. Our data showed a higher sensitivity when specimens contained necrosis, which indicated that only specimens with necrosis should be used for PCR to detect tuberculosis.

Original languageEnglish
Pages (from-to)451-458
Number of pages8
JournalJournal of Pathology and Translational Medicine
Volume50
Issue number6
DOIs
Publication statusPublished - 2016 Jan 1

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Tuberculosis
Polymerase Chain Reaction
Necrosis
Bacillus
Acids
Granuloma
Interferons
Coloring Agents
Staining and Labeling
Antigens
Genes

Keywords

  • Interferon-γ release tests
  • Mycobacterial culture
  • Polymerase chain reaction
  • Tuberculosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Does polymerase chain reaction of tissue specimens aid in the diagnosis of tuberculosis? / Lee, Yoo Jin; Kim, Seojin; Kang, Youngjin; Jung, Jiyoon; Lee, Eunjung; Kim, Joo Young; Lee, Jeong Hyeon; Lee, Youngseok; Chae, Yang Seok; Kim, Chul Hwan.

In: Journal of Pathology and Translational Medicine, Vol. 50, No. 6, 01.01.2016, p. 451-458.

Research output: Contribution to journalArticle

Lee, Yoo Jin ; Kim, Seojin ; Kang, Youngjin ; Jung, Jiyoon ; Lee, Eunjung ; Kim, Joo Young ; Lee, Jeong Hyeon ; Lee, Youngseok ; Chae, Yang Seok ; Kim, Chul Hwan. / Does polymerase chain reaction of tissue specimens aid in the diagnosis of tuberculosis?. In: Journal of Pathology and Translational Medicine. 2016 ; Vol. 50, No. 6. pp. 451-458.
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abstract = "Background: Mycobacterial culture is the gold standard test for diagnosing tuberculosis (TB), but it is time-consuming. Polymerase chain reaction (PCR) is a highly sensitive and specific method that can reduce the time required for diagnosis. The diagnostic efficacy of PCR differs, so this study determined the actual sensitivity of TB-PCR in tissue specimens. Methods: We retrospectively reviewed 574 cases. The results of the nested PCR of the IS6110 gene, mycobacterial culture, TB-specific antigen-induced interferon-γ release assay (IGRA), acid-fast bacilli (AFB) staining, and histological findings were evaluated. Results: The positivity rates were 17.6{\%} for PCR, 3.3{\%} for the AFB stain, 22.2{\%} for mycobacterial culture, and 55.4{\%} for IGRA. PCR had a low sensitivity (51.1{\%}) and a high specificity (86.3{\%}) based on the culture results of other studies. The sensitivity was higher (65.5{\%}) in cases with necrotizing granuloma but showed the highest sensitivity (66.7{\%}) in those with necrosis only. The concordance rate between the methods indicated that PCR was the best method compared to mycobacterial culture, and the concordance rate increased for the methods using positive result for PCR or histologic features. Conclusions: PCR of tissue specimens is a good alternative to detect tuberculosis, but it may not be as sensitive as previously suggested. Its reliability may also be influenced by some histological features. Our data showed a higher sensitivity when specimens contained necrosis, which indicated that only specimens with necrosis should be used for PCR to detect tuberculosis.",
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