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Korean Journal of Otorhinolaryngology-Head and Neck Surgery > Volume 39(12); 1996 > Article
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1996;39(12): 2064-8.
Dianosis of Cervical Tuberculous Lymphadenitis by Polymerase Chain Reaction : Preliminary Study
Chung-Hwan Beak, MD1, Myung-Koo Kang, MD2, Jun Hur, MD2, and Lee-Suk Kim, MD2
1;Department of Otolaryngology-Head & Neck Surgery, Samsung Medical Center, Seoul, 2;Department of Otolaryngology-Head & Neck Surgery, College of Medicine, Dong-A University, Pusan, Korea
중합효소 연쇄반응을 이용한 경부 결핵성 림프절염의 진단 : 예비적 실험
백정환1 · 강명구2 · 허 준2 · 김리석2
삼성서울병원 이비인후과1;동아대학교 의과대학 이비인후과학교실2;
ABSTRACT

It is often difficult to diagnose cervical tuberculous lymphadenitis by conservative methods such as Mantoux test, fine needle aspiration cytology with acid-fast bacilli(AFB) staining, chest X-ray, and sputum AFB smear. Surgical biopsy, excisional or incisional, is occasionally performed for the diagnosis. Culture of Mycobacterium tuberculosis for confirming the diagnosis of tuberculosis is a time-consuming procedure which takes as long as 10 weeks and has low positive rate. The polymerase chain reaction(PCR) is the method to amplify discrete fragments of DNA of target material in extremely small amount and it has been proven as a useful and rapid procedure for the diagnosis of tuberculosis with various clinical specimens such as sputum and cerebral spinal fluid, etc. We performed the polymerase chain reaction for rapid identification of Mycobacterium tuberculosis with 23 paraffin-embedded cervical lymph node samples which had been pathologically and empirically proven as cervical tuberculous lymphadenitis. The positive PCR products by using oligonucleotide primers, TB-1A(5'-GAACAATCCGGAGTTGACAA-3') and TB-1B(5'-AGCACGCTGTCAATCATGTA-3'), derived from the sequence of a gene coding for the MPB70 antigen, was identified as a single band of DNA 372-bp in size on ethidium bromide-stained agarose gel eletrophoresis. Each PCR product was digested with SacI restriction endonuclease and identified as two DNA bands of 216-bp and 156-bp on agarose gel electrophoresis. This result strongly suggests that the amplified products contain sequenes of M. tuberculosis. In this study, we obtained positive PCR results for 9 of 23 paraffin-embedded tissues. On the basis of preliminary study, we'll verify the usefulness of PCR technique for the diagnosis of cervical tuberculous lymphadenitis without surgical biopsy.

Keywords: Polymerase chain reactionMycobacterium tuberculosisMPB70 antigen.
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