反射CMV免疫组织化学在患有炎症性肠病的患者中的实用性
Melek Buyuk1, Neslihan Berker1, Dogu Vuralli Bakkaloglu1
1Department of Pathology, Istanbul University Istanbul Faculty of Medicine, ISTANBUL, TÜRKİYE.
细胞巨乳病毒 (CMV) 免疫组织化学对于诊断炎症性肠病 (IBD) 患者的CMV感染非常有价值,即使没有明显的病毒变化. 这种反射测试有助于及时诊断和管理CMVIBD患者.
科学领域:
- 胃肠病学 胃肠病学
- 病毒学 病毒学
- 病理学 病理学 病理学
背景情况:
- 细胞巨乳病毒 (CMV) 感染是炎症性肠病 (IBD) 患者的一个重大问题.
- 准确及时诊断CMV感染对于有效管理IBD爆发至关重要.
- 传统的诊断方法在IBD活检中检测CMV时可能存在局限性.
研究的目的:
- 调查CMV免疫组织化学 (IHC) 阳性和IBD患者的临床,内镜和组织学发现之间的关联.
- 评估CMV IHC的诊断效用,作为IBD活检例行基因病学评估中的反射测试.
- 将CMV IHC结果与组织CMV PCR发现进行比较.
主要方法:
- 在2018年至2021年期间对191名IBD患者 (性结肠炎和克罗恩病) 的回顾性分析.
- 分析临床数据,内镜评分,组织学活性 (简化盖博斯评分),细胞病变,CMV IHC和组织CMV PCR.
- CMV IHC 发现与其他临床和实验室参数的相关性.
主要成果:
- 在32.4%的病例中,CMV IHC呈阳性,与性结肠炎显著相关,症状呈现,广泛的结肠参与,高组织学活性和.
- 74.2%的CMV IHC阳性病例缺乏CMV感染的先前临床怀疑.
- 在PCR阳性病例中,CMV IHC与组织PCR显著相关 (p < 0.001),免疫阳性细胞数量较高.
- 病毒性细胞病变仅在30.6%的IHC阳性病例中观察到.
结论:
- 对于评估IBD内镜活检的病理学家来说,CMV免疫组织化学是一种有价值的反射测试,特别是在严重的组织学炎症的情况下.
- 这种方法可以提高CMV感染的检测,即使在H&E染色上没有明显的病毒细胞病变效应.
- 在IBD患者中,CMV IHC可以促进早期诊断和CMV感染的适当管理.
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