Analysis of the prevalence of positivity for tuberculosis infection in formalin-fixed paraffin-embedded tissue.
- 1Department of Pathology, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical University, 19 Xiuhua Road, Haikou, Hainan Province, 570311, China.
- 2Medical Laboratory Center, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical University, Hainan Province, Haikou, 570311, China.
- 3Department of Pathology, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical University, 19 Xiuhua Road, Haikou, Hainan Province, 570311, China. [email protected].
Abstract
Background
The objective of this study was to analyze the tuberculosis(TB) positivity rate of formalin-fixed paraffin-embedded (FFPE) tissue samples, to explore the difference between the positivity rates of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB), and to compare the value of fluorescent probe-based polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis DNA (TB-DNA) and modified Ziehl-Neelsen acid-fast staining (Z-N staining) in the diagnosis of tuberculosis.Methods
A total of 491 patients with histopathological suspected TB admitted to Hainan General Hospital from October 2022 to March 2024 were enrolled. FFPE tissue samples were collected from all participants and examined by fluorescence probe PCR for TB-DNA, acid‑fast staining, and hematoxylin-eosin (H&E) staining. The positive detection rates of TB among different assays were compared. With fluorescent probe PCR results serving as the reference standard, the diagnostic performance of modified Z-N staining was further evaluated. Count data were analyzed using the chi-square test, and a fourfold table was applied to assess the diagnostic efficacy.Results
TB was detected by PCR in 278 cases and by modified Z-N staining in 89 cases. analysis revealed that age, modified Z-N staining results, musculoskeletal tuberculosis (MSTB), and intra-abdominal tuberculosis were significantly associated with TB-PCR results (P < 0.05). The median age was 52 years (interquartile range [IQR]: 37-65 years). Among FFPE tissue samples, the highest proportion of PCR positivity was found in the young group (18-44 years) at 65.97%, while the highest proportion of PCR negativity was seen in the middle-aged group (45-59 years) at 46.84%. The most common sites of EPTB involvement were the pleura, head and neck, and musculoskeletal system, with an overall proportion of 36.46% (179/491). modified Z-N staining was closely correlated with TB-PCR outcomes in both PTB and EPTB subgroups.Conclusions
The use of PCR detection of TB-DNA is more effective than modified Z-N staining for the diagnosis of PTB and EPTB. It is recommended that FFPE tissue samples are prioritised for screening for Mycobacterium tuberculosis by PCR to speed up the diagnosis of TB.Clinical trial
Not applicable.
Related
- Genome Sequencing Outperforms Exome Sequencing in Formalin‐Fixed Paraffin Embedded Tumors Leading to Improved Treatment Options
- Web-based Cellpose‑SAM segmentation enables quantification of cross-sectional area in formalin-fixed paraffin-embedded skeletal muscle sections stained with hematoxylin and eosin
- Association of Postoperative Stress Hyperglycemia Ratio with Suspected Infection, Culture Positivity, Sepsis, and Septic Shock in 1408 Patients After Cranial Neurosurgery
- Association of Pluslife MiniDock MTB time-to-positivity with tuberculosis bacterial load: a diagnostic study in Indonesia
- The Enferplex Bovine TB antibody test shows a significant degree of positivity in both restricted and officially tuberculosis free herds in a national study of bulk tank milk samples from dairy herds in Great Britain
BibTeX
@article{wu2026analysis,
title = {{Analysis of the prevalence of positivity for tuberculosis infection in formalin-fixed paraffin-embedded tissue.}},
author = {Yu Wu and Sha-Sha Hu and Shan-Yong Wang and Shu Chen and Bo Wang},
journal = {BMC infectious diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14175-9},
url = {https://europepmc.org/article/MED/42972510},
note = {CC BY},
}
RIS
TY - JOUR
TI - Analysis of the prevalence of positivity for tuberculosis infection in formalin-fixed paraffin-embedded tissue.
AU - Yu Wu
AU - Sha-Sha Hu
AU - Shan-Yong Wang
AU - Shu Chen
AU - Bo Wang
PY - 2026
DA - 2026/08/05
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14175-9
UR - https://europepmc.org/article/MED/42972510
AB - Background The objective of this study was to analyze the tuberculosis(TB) positivity rate of formalin-fixed paraffin-embedded (FFPE) tissue samples, to explore the difference between the positivity rates of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB), and to compare the value of fluorescent probe-based polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis DNA (TB-DNA) and modified Ziehl-Neelsen acid-fast staining (Z-N staining) in the diagnosis of tuberculosis.Methods A total of 491 patients with histopathological suspected TB admitted to Hainan General Hospital from October 2022 to March 2024 were enrolled. FFPE tissue samples were collected from all participants and examined by fluorescence probe PCR for TB-DNA, acid‑fast staining, and hematoxylin-eosin (H&E) staining. The positive detection rates of TB among different assays were compared. With fluorescent probe PCR results serving as the reference standard, the diagnostic performance of modified Z-N staining was further evaluated. Count data were analyzed using the chi-square test, and a fourfold table was applied to assess the diagnostic efficacy.Results TB was detected by PCR in 278 cases and by modified Z-N staining in 89 cases. analysis revealed that age, modified Z-N staining results, musculoskeletal tuberculosis (MSTB), and intra-abdominal tuberculosis were significantly associated with TB-PCR results (P < 0.05). The median age was 52 years (interquartile range [IQR]: 37-65 years). Among FFPE tissue samples, the highest proportion of PCR positivity was found in the young group (18-44 years) at 65.97%, while the highest proportion of PCR negativity was seen in the middle-aged group (45-59 years) at 46.84%. The most common sites of EPTB involvement were the pleura, head and neck, and musculoskeletal system, with an overall proportion of 36.46% (179/491). modified Z-N staining was closely correlated with TB-PCR outcomes in both PTB and EPTB subgroups.Conclusions The use of PCR detection of TB-DNA is more effective than modified Z-N staining for the diagnosis of PTB and EPTB. It is recommended that FFPE tissue samples are prioritised for screening for Mycobacterium tuberculosis by PCR to speed up the diagnosis of TB.Clinical trial Not applicable.
SN - 1471-2334
ER -