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Immunocytochemistry versus nucleic acid amplification in fine needle aspirates and tissues of extrapulmonary

Madhu Mati Goel1, Puja Budhwar, Amita Jain

  • 1Department of Pathology, Chhatrapati Shahuji Maharaj Medical University (erstwhile King George's Medical University) Lucknow, India.

Journal of Cytology
|November 1, 2012
PubMed

Insights

Immunocytochemistry (ICC) offers a sensitive and specific method for diagnosing extrapulmonary tuberculosis (EPTB), outperforming nucleic acid amplification tests, especially with archival samples. This technique aids in visualizing Mycobacterium tuberculosis antigens for improved EPTB diagnosis.

Area of Science:

  • Medical diagnostics
  • Infectious disease pathology
  • Immunohistochemistry

Background:

  • Immunocytochemistry (ICC) is a standard tool for tumor diagnosis but is underutilized for tuberculosis detection.
  • Accurate diagnosis of extrapulmonary tuberculosis (EPTB) remains challenging.

Purpose of the Study:

  • To evaluate immunocytochemistry (ICC) for direct visualization of Mycobacterium tuberculosis antigens in EPTB specimens.
  • To establish an objective diagnostic method for EPTB using species-specific monoclonal antibodies.

Main Methods:

  • Immunostaining using a monoclonal antibody to the 38-kDa antigen of Mycobacterium tuberculosis complex was performed.
  • The study analyzed fresh and archival fine needle aspirates and tissue granulomas from 302 EPTB cases and 386 controls.
  • Results were compared with nucleic acid amplification (NAA), Ziehl-Neelsen (ZN) staining, and cytomorphology.

Main Results:

  • ICC achieved diagnostic indices of 96-98%, significantly higher than nucleic acid amplification (NAA) at 64-76%.
  • ICC demonstrated consistent sensitivity and specificity with both fresh and archival materials.
  • NAA sensitivity varied significantly between fresh and archival samples, highlighting limitations with stored specimens.

Conclusions:

  • ICC is a sensitive, specific, and superior diagnostic technique compared to NAA for EPTB.
  • ICC can be effectively utilized on archival smears and formalin-fixed paraffin-embedded tissues.
  • ICC serves as a valuable adjunct to conventional methods like morphology and ZN staining for EPTB diagnosis.
Abstract

Keywords:
Extrapulmonaryfine needle aspirationimmunocytochemistrynucleic acid amplificationpolymerase chain reactionpulmonarytuberculosis

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