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Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn's disease

Title
Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn's disease
Authors
Jin, XJ[Jin, Xian Ji]Kim, JM[Kim, Joon Mee]Kim, HK[Kim, Hyung Kil]Kim, L[Kim, Lucia]Choi, SJ[Choi, Suk Jin]Park, IS[Park, In Suh]Han, JY[Han, Jee Young]Chu, YC[Chu, Young Chae]Song, JY[Song, Ju Young]Kwon, KS[Kwon, Kye Sook]Kim, EJ[Kim, Eun Joo]
DGIST Authors
Kim, EJ[Kim, Eun Joo]
Issue Date
2010-05-28
Citation
World Journal of Gastroenterology, 16(20), 2496-2503
Type
Article
Article Type
Article
Keywords
Acid Fast BacteriumAdultBacterium CultureClinical FeatureColonoscopyControlled StudyCrohn&aposs DiseaseCrohn DiseaseDifferential DiagnosisEndoscopyGiant CellGranulomaHistopathologyHumanHuman TissueHumansIntermethod ComparisonIntestineIntestine TuberculosisIs6110KitMajor Clinical StudyMicroscopyMpb64Mycobacterium TuberculosisPolymerase Chain ReactionReagent Kits, DiagnosticRetrospective StudiesSensitivity and SpecificityTuberculosisTuberculosis, GastrointestinalTumor Volume
ISSN
1007-9327
Abstract
AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn's disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tubercu/os/s (TB-PCR) would be helpful for differential diagnosis between ITB and CD. METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies. Microscopic features of ITB and CD were reviewed, and eight pathologic parameters were evaluated. Nine cases of acid fast bacilli culture-positive specimens and 10 normal colonic tissue specimens were evaluated as the positive and negative control of the TB-PCR test, respectively. PCR assays were done using two commercial kits: kit detected IS6110 and MPB64, and kit detected IS6110 only; a manual in-house PCR method was also performed on formalin-fixed, paraffin-embedded colonoscopic biopsy specimens. RESULTS: Statistically significant differences were noted between ITB and CD with regard histopathologic criteria: size of granulomas (P = 0.000), giant cells (P = 0.015), caseation necrosis (P = 0.003), confluent granulomas (P = 0.001), discrete granulomas (P = 0.000), and granulomas with lymphoid cuffs (P = 0.037). However, 29 cases (52.7%) of ITB showed less than five kinds of pathologic parameters, resulting in confusion with CD. The sensitivities and specificities of the TB-PCR test by kit , kit , and the in-house PCR method were 88.9% and 100%, 88.9% and 100%, and 66.7% and 100% in positive and negative controls, respectively. The PCR test done on endoscopic biopsy specimens of ITB and CD were significantly different with kit (P = 0.000) and kit (P = 0.000). The sensitivities and specificities of TB-PCR were 45.5% and 88.1%, 36.4% and 100%, and 5.8% and 100%, for kit and kit and in-house PCR method on endoscopic biopsy specimens. Among the 29 cases of histopathologically confusing CD, 10 cases assayed using kit and 6 cases assayed using kit were TB-PCR positive. A combination of histologic findings and TB-PCR testing led to an increase of diagnostic sensitivity and the increase (from 47.3% to 58.2) was statistically significant with kit (P = 0.000). CONCLUSION: The TB-PCR test combined with histopathologic factors appears to be a helpful technique in formulating the differential diagnosis of ITB and CD in endoscopic biopsy samples. © 2010 Baishideng.
URI
http://hdl.handle.net/20.500.11750/3522
DOI
10.3748/wjg.v16.i20.2496
Publisher
Baishideng Publishing Group Inc.
Related Researcher
Files:
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Collection:
Companion Diagnostics and Medical Technology Research Group1. Journal Articles


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