Akurasi Pemeriksaan Polymerase Chain Reaction Menggunakan Primer IS6110 dan MPB64 untuk Mendeteksi Mycobacterium tuberculosis pada Spesimen Formalin-Fixed Paraffin-Embedded
Keywords:
FFPE, IS6110, MPB64, mycobacterium tuberculosis, paraffin, polymerase chain reactionAbstract
Background
One of the chalangges faced in controlling tuberculosis (TB) is the availability of a fast and precise diagnostic
tool. The current gold standard for diagnosis of TB is acid-fast bacterial culture. However, FFPE (formalin-fixed
paraffin-embedded) tissues are not ammenable for culture and the time required makes this method impractical
for many centers. PCR is an alternative rapid diagnostic tool, and can be used with FFPE tissues. PCR has
shown high sensitivity and specificity for detecting M.tuberculosis, however there has been reports of less
sensitivity and specificity when using FFPE specimens. This report aims to determine the accuracy of PCR
detection of M.tuberculosis using primer IS6110 and MPB64 on FFPE specimens.
Methods
Literature searches were carried out on the Pubmed, Scopus, Proquest, Springer Link and Cochrane
databases. Two journals were relevant to the clinical scenario, then a critical review is carreid out using the
Diagnostic Study Appraisal Worksheet from the Center for Evidence-based Medicine, University of Oxford,
2010.
Results
Currently, the accuracy of PCR primer IS6110 and MPB is not satisfactory. Sensitivity ranges from 45.5-88.9%
and specificity is between 88.1% - 100. This broad sensitivity range is probably caused by tissue volume and
embedding process that can cause damages to the integrity of M.tuberculosis DNA.
Conclusion
PCR examinations using IS6110 and MPB64 primers can be used as confirmation tests in FFPE specimens
due to its high specificity value. Broad sensitivity values can produce significant false negatives if no other
examination is used in conjunction with PCR in FFPE specimens.