摘要目的：通过免疫组织化学方法检测石蜡包埋组织标本中结核分枝杆菌分泌蛋白Ag85B的表达，并探讨其在结核病病理学诊断中的应用价值。方法收集2012年1月至2013年7月首都医科大学附属北京胸科医院病理科结核病石蜡包埋组织标本105例（肺结核54例、淋巴结核51例）及其他疾病石蜡包埋组织标本51例（肺癌8例、肺脓肿10例、支气管扩张症10例、淋巴瘤7例、坏死性淋巴结炎5例、淋巴结反应性增生4例、结节病7例）。免疫组织化学检测采用一步法，用Ag85B抗体进行。同时做抗酸染色进行对比研究。结果免疫组织化学法与抗酸染色检测结果显示，组织标本中Ag85B表达部位及强度与抗酸杆菌的分布部位及数量一致。免疫组织化学法的阳性率为50.5％（53/105），显著高于抗酸染色法的阳性率31.4％（33/105；χ2＝7.877，P＝0.005）。而两种方法联合检测阳性率可达到59.0％。此外，免疫组织化学法不使用油镜，可大幅提高病理医师阅片诊断速度。结论利用Ag85B抗体进行的免疫组织化学染色方法简单易行，与抗酸染色法相比可提高阳性检出率，在结核病的病理学诊断中具有良好的应用价值。

abstractsObjective To detect the expression of Mycobacterium tuberculosis secreted protein Ag85B in paraffin-embedded tissues by immunohistochemistry (IHC), and to evaluate its application in the pathological diagnosis of tuberculosis.Methods One hundred and five tuberculosis specimens (54 pulmonary tuberculosis, 51 lymph nodal tuberculosis ) and 51 specimens of other diseases (8 lung cancer, 10 pulmonary abscess, 10 bronchiectasis, 7 lymphoma, 5 necrotizing lymphadenitis, 4 reactive hyperplasia lymphoid , and 7 sarcoidosis ) were collected from January 2012 to July 2013 from Beijing Chest Hospital, Capital Medical University.One-step IHC was performed on paraffin-embedded tissues using antibody directed against Ag85B.Results IHC and Ziehl-Neelsen ( ZN) acid-fast staining showed that distribution and intensity of Ag85B expression were concordant with the distribution and number of acid-fast bacilli.IHC showed significantly higher sensitivity than ZN staining (50.5%,53/105 vs.31.4%,33/105;χ2 =7.877, P=0.005).The combined sensitivity of IHC and ZN staining was 59.0%.Moreover, oil immersion was not necessary for IHC , allowing more rapid diagnosis.Conclusion IHC detection of Ag85B is a simple method with higher sensitivity than ZN staining , and demonstrated good value in the pathological diagnosis of tuberculosis.