ArticleFrontiers in medicine2026
Optimizing pathological diagnosis of tuberculosis: qPCR outperforms acid-fast staining in formalin-fixed paraffin-embedded tissues and enables resistance profiling.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Objective: Accurate detection of Methods: We analyzed 1,050 FFPE tissue specimens that were histopathologically diagnosed as granulomatous inflammation suggestive of tuberculosis. All specimens underwent parallel testing with both qPCR (using the NMPA-approved kit) and AFB staining. Drug resistance testing was conducted on qPCR positive samples (Ct ≤ 35; Results: The cohort, with a median age of 52 years and comprising 43.71% males, included 631 surgical specimens and 419 biopsy specimens, predominantly sourced from lung tissues (37.05%) and lymph nodes (24.67%). qPCR demonstrated a higher positive rate compared to AFB staining (63.43% vs. 26.29%, Conclusion: This study demonstrates that the qPCR kit approved by the NMPA and optimized for FFPE tissue samples exhibits high effectiveness in the pathological diagnosis of tuberculosis when culture methods are not feasible. Its performance significantly surpasses that of AFB staining. Using DNA extracted from a single FFPE tissue section, we established an integrated molecular testing strategy. This approach enables the sensitive detection of MTB through qPCR, demonstrating a higher detection rate compared to AFB staining in FFPE tissues. Furthermore, it facilitates subsequent drug resistance analysis and the differentiation of NTM species from the same DNA sample, thereby providing a practical and efficient solution for comprehensive pathological diagnosis.
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