Can an Immunohistochemistry Method Differentiate Intestinal  Tuberculosis from Crohn’s Disease in Biopsy Specimens?

Can an Immunohistochemistry Method Differentiate Intestinal Tuberculosis from Crohn’s Disease in Biopsy Specimens?

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Ali Tu¨zu¨n _Ince Pembegu¨l Gu¨nes¸ Ebubekir S¸ enates¸ Mesut Sezikli Arzu Tiftikc¸i Oya O¨ vu¨nc
  • چاپ و سال / کشور: 2010

Description

Background It is sometimes difficult to diagnose whether a patient has intestinal tuberculosis or Crohn’s disease because both have similar clinical, pathologic, and endoscopic features. However, their therapies are completely different and a mistake in diagnosis can result with deterioration. Many laboratory methods for the diagnosis of tuberculosis require considerable time to receive a diagnostic result. We wanted to evaluate whether an immunohistochemical tuberculosis staining method can be helpful for faster differentiation of biopsy materials. Methods We used formalin-fixed paraffin-embedded histologically diagnosed small intestine (n = 1), colon (n = 7), skin (n = 8), lung (n = 5), lymph node (n = 24) tuberculosis and Crohn’s disease (n = 28) biopsy materials only with granulomas. Demographic characteristics like age and gender were also obtained. Pathology specimens were stained immunohistochemically with an antibody to VP-M660, targeting the 38-kDa antigen of Mycobacterium tuberculosis. Results In the M. tuberculosis group, 33/45 of patients have positive immunohistochemistry (IHC) staining (73% sensitivity, 93% specifity), whereas only two of 28 patients have positive staining in the Crohn’s group (p\0.001). The positive staining with IHC was detected as 85.7, 75, 75, and 60% in colon, lymph node, skin, and lung granulomas, respectively, in M. tuberculosis patients. Conclusions Immunohistochemical staining of biopsy specimens with anti-VP-M660 seems to be a simple and fast technique with 73% sensitivity and 93% specificity for establishing an earlier differentiation of M. tuberculosis from Crohn’s disease
Dig Dis Sci (2011) 56:1165–1170 DOI 10.1007/s10620-010-1399-7 Received: 4 April 2010 / Accepted: 12 August 2010 / Published online: 8 September 2010
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