布鲁氏菌性脊柱炎的临床、组织病理特征分析及分子病理新技术的诊断价值研究

doi:10.3969/j.issn.1006-7795.2026.03.009

首都医科大学学报

布鲁氏菌性脊柱炎的临床、组织病理特征分析及分子病理新技术的诊断价值研究

杜鹃¹，车佳璐¹，严广璇²，苏丹¹，车南颖^1*

1.首都医科大学附属北京胸科医院病理科，北京 101149；2.首都医科大学附属北京胸科医院骨科，北京 101149

收稿日期:2026-01-12 修回日期:2026-03-12 出版日期:2026-06-21
通讯作者: 车南颖 E-mail:cheny0448@163.com
基金资助:
国家自然科学基金面上项目（82472378）,国家科技重大专项 —— 新发突发及重大传染病防控项目（2025ZD01908700）,北京市医院管理局登峰人才计划（DFL20241601），北京市研究型病房示范建设专项（BRWE2024W042160103）。

Analysis of clinical and histopathological features of brucella spondylitis and diagnostic value of novel molecular pathological techniques

Du Juan¹, Che Jialu¹, Yan Guangxuan², Su Dan¹, Che Nanying^1*

1. Department of Pathology, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing 101149, China; 2. Department of Orthopedics, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing 101149, China

Received:2026-01-12 Revised:2026-03-12 Online:2026-06-21
Supported by:
This study was supported by the General Program of the National Natural Science Foundation of China (82472378), Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project (2025ZD01908700), Dengfeng Talents Project of Beijing Hospitals Authority (DFL20241601), and Beijing Research Ward Excellence Program (BRWE2024W042160103).

摘要/Abstract

摘要： 目的本研究通过综合分析临床病理学特点，比较特殊染色和分子病理的病原学检测能力，为病理学诊断布鲁氏菌性脊柱炎（Brucella spondylitis, BS）提供新技术途径。方法回顾性分析首都医科大学附属北京胸科医院2016年10月至2025年10月收治的经病原学或血清学证实的86例布鲁氏菌性脊柱炎患者的临床资料、影像学表现、组织病理学特点，并对其经石蜡包埋的病理组织样本进行吉姆萨染色，弱抗酸染色和布鲁氏菌属特异性实时荧光定量聚合酶链式反应（quantitative real-time polymerase chain reaction, qRT-PCR）检测。结果组织病理学显示淋巴细胞及浆细胞浸润（54.7%）、嗜酸性粒细胞浸润（37.2%）、中性粒细胞浸润（44.2%），炎性肉芽组织形成（22.1%），伴不同程度的骨质破坏（41.9%），部分病例还可见小灶坏死（12.3%）、纤维结缔组织增生性病变（19.8%）、组织细胞及泡沫细胞聚集成片（11.6%），小部分病例可见多核巨细胞浸润伴肉芽肿性病变形成（8.1%）。吉姆萨染色阳性率为33.7%，弱抗酸染色阳性率为23.3%。qRT-PCR检测显示，86例病例中54例（62.79%）布鲁氏菌属特异性靶标呈阳性，且IS711的阳性率（62.79%）显著高于bcsp31（46.51%）（P <0.01）；IS711 qRT-PCR联合吉姆萨染色的阳性检出率（67.44%）略高于单独IS711 qRT-PCR（62.79%），但两者差异无统计学意义（P>0.05）。结论 BS具有特征性的临床-影像-病理三联征，通过观察其组织病理学特点，辅以特殊染色及分子病理学技术可以有效地提高BS的病理学诊断准确性。

关键词: 布鲁氏菌性脊柱炎, 临床特征, 组织病理学, 分子病理学, 实时荧光定量聚合酶链式反应, 吉姆萨染色

Abstract: Objective To analyze the clinicopathological characteristics of Brucella spondylitis (BS) and compare the pathogen detection capabilities of special staining and molecular pathology techniques, thereby providing a novel technical approach for the pathological diagnosis of BS.Methods A retrospective analysis was conducted on the clinical data, imaging findings and histopathological features of 86 BS patients were confirmed by etiological or serological tests, who were admitted to Beijing Chest Hospital Affiliated to Capital Medical University from October 2016 to October 2025. Paraffin-embedded pathological tissue samples of these patients were subjected to Giemsa staining, weak acid-fast staining and Brucella-specific quantitative real-time polymerase chain reaction (qRT-PCR) detection.Results Histopathological examination revealed lymphocyte and plasma cell infiltration (54.7%), eosinophil infiltration (37.2%), neutrophil infiltration (44.2%), and inflammatory granulation tissue formation (22.1%), accompanied by varying degrees of bone destruction (41.9%). In some cases, focal necrosis (12.3%), fibrous connective tissue proliferative lesions (19.8%) and sheets of histiocytes and foam cells (11.6%) were also observed, while a minority of cases showed multinucleated giant cell infiltration with granulomatous lesion formation (8.1%). The positive rate of Giemsa staining was 33.7%, and that of weak acid-fast staining was 23.3%. The results of qRT-PCR showed that 54 out of 86 cases (62.79%) were positive for Brucella-specific targets. Notably, the positive rate of IS711 (62.79%) was significantly higher than that of bcsp31 (46.51%) (P < 0.01). The combined positive detection rate of IS711 qRT-PCR and Giemsa staining was 67.44%, which was slightly higher than that of IS711 qRT-PCR alone (62.79%), without statistically significant difference (P > 0.05).Conclusion BS presents is characterized by clinical-imaging-pathological triad. Histopathological evaluation, supplemented by special staining and molecular pathological techniques, can effectively improve the accuracy of pathological diagnosis of BS.

Key words: Brucella spondylitis, clinical characteristics, histopathology, molecular pathology, qRT-PCR, Giemsa staining

中图分类号:

R365

杜鹃, 车佳璐, 严广璇, 苏丹, 车南颖. 布鲁氏菌性脊柱炎的临床、组织病理特征分析及分子病理新技术的诊断价值研究[J]. 首都医科大学学报, doi: 10.3969/j.issn.1006-7795.2026.03.009.

Du Juan, Che Jialu, Yan Guangxuan, Su Dan, Che Nanying. Analysis of clinical and histopathological features of brucella spondylitis and diagnostic value of novel molecular pathological techniques[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2026.03.009.

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布鲁氏菌性脊柱炎的临床、组织病理特征分析及分子病理新技术的诊断价值研究

Analysis of clinical and histopathological features of brucella spondylitis and diagnostic value of novel molecular pathological techniques

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