目的 結核分枝桿菌引起的結核病是世界上最重要的傳染病之一。由組織作分枝桿菌培養或自組織的病理切片作抗酸染色證實有分枝桿菌是傳統的確診方法，但是兩種傳統診斷方法的診斷率都很低，而且相當耗費時間與人力。自1986年核酸的聚合酶鏈反應法被開發以來，這種能快速且有效偵測微量核酸的方法就被廣泛的使用於特定核酸片段的偵測，包括各種微生物之核酸。方法 本研究自16例抗酸染色陽性病例和17例抗酸染色陰性病例的福馬林固定石蠟包埋的病理組織切片中，以聚合酶鏈反應法偵測分枝桿菌DNA片段並與組織化學染色結果做比較。結果 本研究中以聚合酶鏈反應法發現16例抗酸染色陽性病例和17例抗酸染色陰性病例中各有14例在石蠟組織切片中有分枝桿菌DNA片段。以聚合酶鏈反應法偵測分枝桿菌DNA片段的靈敏性和特殊性，顯然比傳統診斷結核菌感染的細菌培養和抗酸染色要高。結論 以靈敏的聚合酶鏈反應怯偵測微量DNA片段在偵測病理切片中的分枝桿菌是非常有效的方怯，本文強烈建議在病理科室設立高品管的分子病理實驗室，將可以大幅增加結核菌感染的診斷率。
Objectives. Tuberculosis caused by Mycobacterium tuberculosis is one of the most common infectious diseases worldwide. Pathologic confirmation by demonstrating mycobacterial bacillus in tissue section using histochemical stain or culture is the traditional diagnostic method. However, the diagnostic rate by both histochemical stain and culture is low. Polymerase chain reaction (PCR) is able to detect trace amounts of nucleic acid in paraffin sections. We detected mycobacterial DNA in pathological samples by PCR and compared the results with those of histochemical stain and culture. Methods. Formalin-fixed paraffin-embedded tissue sections of 16 acid-fast positive and 17 acid- fast negative tissue samples showing granulomatous inflammation were retrieved retrospectively for PCR study. Results. PCR detected mycobacterial DNA in 14 out of 16 acid-fast positive and 14 out of 17 acid- fast negative samples. The sensitivity and specificity for detecting Mycobacterium by PCR were much higher than acid-fast stain and culture. Conclusions. PCR method was very useful in detecting mycobacterial infection in pathologic sections. We believe that the establishment of the PCR method in the department of pathology will improve the quality of clinical and pathologic diagnosis of tuberculosis.
