Rapid and Specific Diagnosis of Extrapulmonary Tuberculosis by Immunostaining of Tissues and Aspirates With Anti-MPT64

Appl Immunohistochem Mol Morphol. 2017 Apr;25(4):282-288. doi: 10.1097/PAI.0000000000000300.

Abstract

Background: Extrapulmonary tuberculosis (EPTB) constitutes about 15% to 20% of all cases of tuberculosis (TB). The confirmation of EPTB has always been a challenge to laboratory personnel. We aim to evaluate the diagnostic potential of immunostaining with anti-MPT64 in various EPTB specimens.

Materials and methods: We studied a total of 51 TB cases and 38 non-TB control specimens comprising of fine-needle aspirates and formalin-fixed biopsies. These were investigated using a combination of the Ziehl-Neelsen method, the Lowenstein-Jensen culture, immunostaining with anti-MPT64 and anti-BCG, and nested-polymerase chain reaction (PCR) for IS6110. Results of all the tests were compared using nested-PCR as the gold standard.

Results: Diagnostic validation of immunostaining for anti-MPT64 was performed using nested-PCR as the gold standard. The overall sensitivity, specificity, and positive and negative predictive values for immunostaining with anti-MPT64 were 100%, 97%, 97%, and 100%, respectively.

Conclusions: Immunostaining using anti-MPT64 is a rapid and sensitive method for establishing an early and specific diagnosis of Mycobacterium tuberculosis infection. The technique is simple to be incorporated into routine pathology laboratories.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Bacterial / immunology*
  • Biopsy, Fine-Needle
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / microbiology
  • Lymph Nodes / pathology*
  • Mycobacterium tuberculosis / physiology*
  • Pleura / microbiology
  • Pleura / pathology*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Tuberculosis / diagnosis*

Substances

  • Antigens, Bacterial
  • MPT64 protein, Mycobacterium tuberculosis