기관지내시경을 이용하여 획득한 조직검체에서 결핵균 검출을 위한 중합효소연쇄반응 검사의 유용성

Abstract

Background: Pulmonary tuberculosis is an important public health issue. Early diagnosis with subsequent treatment is necessary for successful patient outcomes. However, diagnosis of pulmonary tuberculosis is difficult in cases with an unusual presentation and often requires a lung biopsy. The goal of this study was to determine the clinical usefullness of PCR on lung tissue sample for the diagnosis of pulmonary tuberculosis.

Method: The subject of this study included 31 patients who underwent transbronchial lung biopsy followed by TB-PCR on formalin-fixed paraffin-embedded lung tissue specimens at the Chosun University Hospital (Gwangju, Republic of Korea) from February 2007 to November 2011. The diagnostic yield and clinical impact of PCR were investigated.

Result: Out of 31 patients, 15 were diagnosed with tuberculosis based on the clinical findings. Based on the clinical finding, sensitivity, specificity, positive predictability, and negative predictability of the tissue sample TB-PCR were 53.3%, 100%. 100%, and 69.5% respectively. Three of the 15 cases, sputum AFB stain and sputum TB-PCR were negative but positive value in tissue sample TB-PCR. The TB-PCR results in tissue sample show a potential role in early diagnosis and initiation of treatment for pulmonary tuberculosis. The relatively low sensitivity limit the use of this test in the detection of the pulmonary tuberculosis.

Conclusion: TB-PCR in tissue sample is an important diagnostic tool for diagnosing tuberculosis.

Key words: tuberculosis, tissue sample, PCR