Study on the pathological diagnostic value of spinal tuberculosis lesions with different submitting methods and tissue types.

objectivesTo investigate the pathological diagnostic value of spinal tuberculosis (STB) lesions with different submitting methods and tissue types, provide a reference for accurate submission of STB tissue specimens, and improve the accuracy of pathological diagnosis.

methodsThe clinical data and intraoperative lesion specimens of 68 STB patients surgically treated in the Department of Orthopedics of General Hospital of Ningxia Medical University from June 2019 to October 2022 were collected and divided into two groups according to the different ways of submitting lesion tissues for examination. In group A, the lesion tissues were submitted for examination separately, including granulation tissues, vertebral lesion bone tissues, and intervertebral discs for pathological examination; in group B, all lesion specimens were mixed and submitted for pathological examination. Group A included 34 cases, 19 males and 15 females, while Group B included 34 cases, 17 males and 17 females. The tissue specimens were routinely decalcified, dehydrated, embedded, sectioned, and stained with hematoxylin-eosin (HE), and the typical and atypical pathological changes of STB were observed under a high-power microscope. Observe the accuracy rate of pathological diagnosis of different lesion tissues in Group A, and carry out comparative analysis within the group; meanwhile, compare and analyze the difference in pathological diagnosis between Group A and B. Ten cases of clinically suspected STB were selected to undergo lesion tissue puncture biopsy, of which 6 cases were male and 4 cases were female, to obtain suspected granulation tissue, vertebral lesion bone tissue, and intervertebral discs for pathological examination, and to compare and analyze the difference between pathological diagnosis of the preoperative puncture specimens and the final diagnosis after operation.

resultsIn Group A, 27 granulation tissues, 34 vertebral lesion bone tissues, and 30 intervertebral discs were sent for examination respectively, and the accuracy of pathologic diagnosis was 59.3%, 44.1%, and 26.7%. Of the 34 STB patients in Group A, 28 were pathologically diagnosed as STB by comprehensive analysis of granulation tissue, vertebral lesion bone tissue, and intervertebral disc, and the overall pathological diagnostic accuracy rate in Group A was 82.4%. The difference between the overall pathological diagnostic accuracy of group A compared with the independent pathological detection rates of granulation tissue, vertebral lesion bone tissue, and intervertebral disc tissue was statistically significant (P < 0.05); The difference in the accuracy of pathological diagnosis between granulation tissue, intervertebral disc tissue and vertebral lesion bone tissue was not statistically significant in group A (P > 0.05); the difference in the rate of pathological diagnosis between granulation tissue and intervertebral disc tissue was statistically significant (P < 0.05). Thirty-four samples were submitted for examination in Group B, and the accuracy rate of pathological diagnosis was 58.8%. The difference between the overall pathological detection rate of Group A and that of Group B was statistically significant (P < 0.05). Ten cases of clinically suspicious STB were selected for lesion tissue puncture biopsy; suspicious granulation tissue, vertebral lesion bone tissue, and intervertebral disc tissue were sent for examination in 9, 10, and 9 pieces, respectively, and the accuracy rates of pathological diagnosis were 44.4%, 60.0%, and 33.3%, respectively; the comprehensive analysis of mixed lesion tissue supported the diagnosis of STB in 8 out of 10 cases. However, due to the small sample size, these findings should be considered exploratory and warrant validation in larger cohorts.

conclusionsThe accuracy of pathological diagnosis of STB lesion tissues submitted separately was higher than that of mixed submission, in which the pathological diagnosis rate of granulation tissue and vertebral bone tissue was higher. It will help to improve the accuracy of pathological diagnosis of STB by submitting STB tissue specimens separately and submitting vertebral lesion bone or granulation tissue by preoperative puncture.