目的　探讨结核杆菌DNA（TB-DNA）测定结合病理形态学检查与结核分枝杆菌∕利福平耐药实时荧光定量核酸扩增（Xpert MTB/RIF）法在病理组织样本中检测结核分枝杆菌的效能。方法　选取2020年9月—2021年12月就诊的疑似结核患者71例,对患者的病理组织（肺、淋巴结、胸膜和其他组织）样本分别进行TB-DNA测定（结合病理形态学检查）和Xpert MTB/RIF检测,比较两种方法在临床诊断中的价值。结果　TB-DNA（结合病理）检测的阳性率为40.8%（29/71）,Xpert MTB/RIF的阳性率为23.9%（17/71）,两者间的差异具有统计学意义（P<0.05）。两种方法的诊断一致性为77.46%（κ=0.502, P<0.05）。以临床最终诊断（综合考虑临床表现、病原学、组织病理学、影像学、对经验性抗结核治疗反应等结果后作出）为标准,TB-DNA和Xpert MTB/RIF检测的灵敏度分别为49.0%（24/49）和30.6%（15/49）,特异度分别为77.3%（17/22）和90.9%（20/22）,差异均无统计学意义（P>0.05）。结论　两种方法在组织样本中对于结核分枝杆菌的检测均具有一定的临床应用价值,TB-DNA法结合病理形态学诊断具有更高的检测阳性率和诊断价值。

Objective To investigate the efficacy of tuberculosis bacillus DNA （TB-DNA） assay combined with pathologic diagnosis and real-time fluorescence quantitative nucleic acid amplification of Mycobacterium tuberculosis/rifampicin resistance（Xpert MTB/RIF） for the detection of Mycobacterium tuberculosis in pathological tissue samples. Methods A total of 71 patients with suspected tuberculosis were selected from September 2020 to December 2021. The pathological tissue samples （lung, lymph nodes, pleura, and other tissues） of the patients were respectively detected by TB-DNA and Xpert MTB/RIF, and the value of the two methods in clinical diagnosis was compared. Results The positive rate of TB-DNA （combined with pathology） was 40.8%, and that of Xpert MTB/RIF was 23.9%, with a statistically significant difference （P<0.05）. The consistency of the two methods was 77.46% （κ=0.502, P<0.05）. Based on the final clinical diagnosis （made after comprehensive consideration of clinical manifestations, etiology, histopathology, imaging, response to empirical anti-tuberculosis therapy, etc.）, the sensitivities of TB-DNA and Xpert MTB/RIF were 49.0% （24/49） and 30.6% （15/49）, and the specificities were 77.3% （17/22） and 90.9% （20/22）, respectively; there was no significant difference in sensitivity and specificity between TB-DNA and Xpert MTB/RIF （P>0.05）. Conclusion Both methods have some value in the detection of Mycobacterium tuberculosis in tissue samples, and TB-DNA combined with pathologic diagnosis may have a higher positive rate and diagnostic value.