Abstract
BackgroundThe purpose of this study was to examine the value of Xpert MTB/RIF assay and detection of additional Mycobacterium tuberculosis complex (MTBC) species antigens from intestinal tissue samples in differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD).MethodsSeveral clinical specimens of intestinal tissue obtained by either endoscopic biopsy or surgical excision were used for mycobacteriologic solid cultures,Xpert MTB/RIF assays, immunohistochemistry, and histological examinations. Four antigens (38KDa, ESAT-6, MPT64, and Ag85 complex) of MTBC in the intestinal tissue were detected by immunohistochemical analysis.ResultsThe study included 42 patients with ITB and 46 with CD. Perianal lesions and longitudinal ulcers were more common in patients with CD, while caseating granuloma and annular ulcers were more common in patients with ITB. The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissues of patients with ITB was 33.33%, which was significantly higher than that in patients with CD and that detected using acid-fast staining smears. It was also higher than that detected by tissue MTBC culture, but the difference was not statistically significant. The positive MPT64 expression rate in patients with ITB was 40.48%, which was significantly higher than that observed in patients with CD. The sensitivity of parallelly combined detection of tuberculosis protein MPT64 and Xpert MTB/RIF in diagnosing ITB was 50.0%.ConclusionsThe detection of Xpert MTB/RIF in intestinal tissue is a rapid and useful method for establishing an early diagnosis of ITB. The detection of MTBC using Xpert MTB/RIF and MPT64 antigen in intestinal tissues has a definitive value in the differential diagnosis ofITB and CD. The combination of these two methods can improve the detection sensitivity.
Highlights
The purpose of this study was to examine the value of Xpert MTB/RIF assay and detection of additional Mycobacterium tuberculosis complex (MTBC) species antigens from intestinal tissue samples in differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD)
Detection and comparison of MTBC in intestinal tissues of patients with ITB and CD The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissues of patients with ITB was 33.33%, which was significantly higher than that of patients with CD (P < 0.01)
The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissue specimens of patients with ITB (33.33%) was higher than that detected by tissue MTBC culture (21.43%), but the difference was not statistically significant
Summary
The purpose of this study was to examine the value of Xpert MTB/RIF assay and detection of additional Mycobacterium tuberculosis complex (MTBC) species antigens from intestinal tissue samples in differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD). The incidence of tuberculosis and ITB has significantly increased following the population migration, drug-resistant bacterial infection, and spread of AIDS [1]. This technology has been gradually recognized and approved for its diagnostic value in tuberculosis detection, showing high accuracy, sensitivity of 89% and specificity of 98% in diagnosing adult pulmonary tuberculosis [7]. Previous studies investigated the diagnostic value of Xpert MTB/RIF in extrapulmonary tuberculosis [8,9,10]. Studies on the application of Xpert MTB/RIF in diagnosing of ITB are still very rare
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