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  Home::Correlation of Anti A-60 antibodies with fine needle aspiration cytology in the diagnosis of tubercu
  Correlation of Anti A-60 antibodies with fine needle aspiration cytology in the diagnosis of tubercu
   

Definitive diagnosis of tubercular (Tb) lymphadenitis requires presence of epithelioid   granuloma   with  caseous necrosis and /or   acid-fast bacilli(AFB)  on fine needle aspiration cytology(FNAC) or AFB culture examination. They   may not be found in many cases. Though molecular methods and Polymerase Chain eactions (PCR) are more accurate, they are   costly   and are not available in many health centres in underdeveloped and developing countries. The purpose of this study is to evaluate the diagnostic utility of Anti A-60 antibodies detection by enzyme linked immune sorbent assay (ELISA) in tubercular   lymphadenitis and correlate with the cytomormorphological features. Sample size was 90 cases which included 60 diagnosed (Group1) and 20 suspected (Group2) cases of TB   lymphadenitis   diagnosed on FNAC and 10 controls (Group3). Sera were   tested by ELISA for anti A-60 IgM, IgA and IgG antibodies. The results were statistically analysed   by statistical package for social sciences software.(SPSS, version 11). IgG antibodies showed the highest sensitivity of 66.67% and 60% and Positive predictive value (PPV) of 95.24% and 85.71% in Group 1 and Group 2 cases respectively followed by IgA and IgM. Two false positive results were obtained in controls. Probability value (P) was significant (<0.05)   for IgG antibodies in Group1 and Group2 cases. There is   great variation in results of Anti A-60   antibodies in   respect to diagnostic accuracy. The   cases in which   definitive cytology features of TB are not seen, either   PCR or molecular tests can be used to improve diagnostic accuracy or in places  where these facilities are not available, therapeutic  trial of anti tubercular treatment(ATT) shall  be given. 



Date: 15, Sep 2012 Posted By: admin
   
 
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