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目的 探讨免疫组织化学(immunohistochemistry,IHC)及PCR技术在淋巴结结核病理学诊断中的应用价值.方法 收集首都医科大学附属北京胸科医院病理科保存的2012年1月至2013年7月之间的48例手术根治切除淋巴结结核患者(结核组)和21例非淋巴结结核患者(非结核组)的石蜡包埋组织标本,分别应用IHC染色、荧光定量PCR和抗酸染色法对标本进行检测,以临床最后诊断为金标准,比较各方法的检测效能.结果 IHC染色、荧光定量PCR及抗酸染色检测的敏感度分别为52.1％ (25/48)、60.4％ (29/48)及27.1％(13/48);IHC染色和荧光定量PCR检测敏感度均高于抗酸染色,差异均有统计学意义(χ2值分别为6.27、10.84, P值分别为0.012、0.001);而IHC(:染色与荧光定量PCR比较,敏感度差异无统计学意义(;X2=0.68,P=0.411).IHC染色、荧光定量PCR及抗酸染色法检测非结核组结果均为阴性,特异度均为100％(21/21).IHC染色、荧光定量PCR及抗酸染色法的阴性预测值分别为47.7％(21/44)、52.5％(21/40)、37.5％(21/56);符合率分别为66.7％(46/69)、72.5％(50/69)、49.3％(34/69),IHC染色、荧光定量PCR均优于抗酸染色法.结论 IHC染色、荧光定量PCR与抗酸染色法相比,可提高阳性检出率,在淋巴结结核的病理学诊断中具有良好应用价值.“,”Objective To evaluate the clinical value of immunohistochemistry (IHC) and polymerase chain reaction (PCR) methods in pathological diagnosis of tuberculous lymphadenitis. Methods Paraffin-embedded tissue specimens from 48 patients with tuberculous lymphadenitis who had undergone radical resection (the tuberculosis (TB) group) and 21 cases with other diseases in lymph node (the non-TB group) were collected during Jan 2012 to Jul 2013 in Beijing Chest Hospital, Capital Medical University. One-step IHC using antibody targeting Ag85B,Taqman fluorescent quantitative PCR and acid-fast staining were conducted. Their diagnostic efficiency were analyzed, taking the clinical final diagnosis as golden standard. Results The IHC and PCR showed significantly higher sensitivity than that of acid-fast staining (χ2 =6.27,P=0.012; χ2 =10.84,P=0.001,respectively),by the results of 52.1％ (25/48) and 60.4％ (29/48) versus 27.1％ (13/48). However, there was no significant difference in sensitivity between IHC and PCR (χ2 =0.68,P=0.411). The detection results of IHC,PCR and acid-fast staining in non-TB group were all negative,with a specificity of 100％ (21/21) for each test. The IHC and PCR had higher negative predictive value and accordance rate than acid-fast staining (47.7％ (21/44),52.5％ (21/40),37.5％ (21/56), respectively; 66.7％ (46/69), 72.5％ (50/69),49.3％ (34/69), respectively). Conclusion IHC and PCR methods are simple and have higher sensitivity compared to acid-fast staining method. IHC and PCR showed good clinical application value in pathological diagnosis of tuberculous lymphadenitis.