Fanaian Naim K, Cohen Cynthia, Waldrop Sandra, Wang Jennifer, Shehata Bahig M
Emory University School of Medicine, Atlanta, GA 30322, USA.
Pediatr Dev Pathol. 2009 May-Jun;12(3):195-9. doi: 10.2350/07-07-0316.1.
Detection of Epstein-Barr virus (EBV) may be achieved by various methods, including EBV-encoded RNA (EBER) in-situ hybridization (ISH) and immunohistochemistry (IHC) for latent membrane protein (LMP-1). We compared novel automated ISH and IHC techniques in pediatric lymphoproliferative disorders with results obtained by manual ISH. Thirty-seven pediatric cases previously studied by manual EBER ISH (including 18 EBER-positive, 15 EBER-negative, and 4 EBER-equivocal cases) were used for the study. Automated EBER ISH and automated LMP-1 IHC were performed using the BondMax autostainer and prediluted EBER probe and EBV cell surface 1 to 4 at 1:50 dilution, respectively. Results of each of the automated techniques for EBV detection were compared with results by manual EBER ISH. Compared with manual EBER ISH as the gold standard, automated ISH had a sensitivity and specificity of 94% and 69%, respectively, accuracy of 83%, positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 90%. Automated IHC had a sensitivity of 44%, specificity of 93%, accuracy of 67%, PPV of 88%, and NPV of 59%. Automated ISH and IHC correlated significantly (P < 0.045). Automated ISH is useful for diagnosis of EBV-related pediatric neoplasms, being easy to perform and interpret and requiring only the technologist's time to set up and having a high sensitivity and NPV The automated IHC protocol is of too low sensitivity for routine use, although results show high specificity and PPV.
检测爱泼斯坦-巴尔病毒（EBV）可通过多种方法实现，包括EBV编码RNA（EBER）原位杂交（ISH）以及针对潜伏膜蛋白（LMP-1）的免疫组织化学（IHC）。我们将新型自动化ISH和IHC技术用于儿科淋巴增殖性疾病，并与手动ISH的结果进行比较。选取了37例先前经手动EBER ISH研究的儿科病例（包括18例EBER阳性、15例EBER阴性和4例EBER结果不明确的病例）用于该研究。分别使用BondMax自动染色仪以及预稀释的EBER探针和按1:50稀释的EBV细胞表面1至4进行自动化EBER ISH和自动化LMP-1 IHC检测。将每种EBV检测自动化技术的结果与手动EBER ISH的结果进行比较。以手动EBER ISH作为金标准，自动化ISH的灵敏度和特异性分别为94%和69%，准确率为83%，阳性预测值（PPV）为79%，阴性预测值（NPV）为90%。自动化IHC的灵敏度为44%，特异性为93%，准确率为67%，PPV为88%，NPV为59%。自动化ISH和IHC显著相关（P < 0.045）。自动化ISH对于诊断EBV相关的儿科肿瘤很有用，操作和解读简便，仅需技术人员设置时间，且灵敏度和NPV高。自动化IHC方案的灵敏度过低，不适合常规使用，尽管结果显示特异性和PPV高。
