Yuste Rosario Sanchez, Frías Carolina, López Ana, Vallejo Carlos, Martín Paloma, Bellas Carmen
Department of Pathology, Hospital Universitario Clínica Puerta de Hierro, Madrid, Spain.
Acta Cytol. 2008 Mar-Apr;52(2):191-5. doi: 10.1159/000325478.
To compare the diagnostic value of cytology and immunohistochemistry staining (IHS) of urine samples for polyomavirus reactivation diagnosis.
Sixty-eight urine samples collected from 18 immunosuppressed patients were analyzed by Papanicolaou and IHS with a JC/BK virus-specific monoclonal antibody.
Overall, polyomavirus BK (BKV) was positive in 11 of 18 patients (61.1%) (3 of whom developed hemorrhagic cystitis) and in 23 of 68 urine samples (28%). Of 23 samples, 4 (17%) were positive by 1 of the 2 techniques, only. Of 23 samples, 19 (83%) were positive by both methods. In matching urine samples from the same patient, the number of BKV-infected positive cells detected by IHS in urine slides was higher than those detected by Papanicolaou staining (71.3%).
The main advantage of LHS is that it allowed confirmation of BKV infection diagnosis in urine samples. IHS detected more BKV-infected cells in samples with few positive urothelial cells, which would have gone undetected if only Papanicolaou staining had been used as the BKV screening method. Urine samples testing for BKV by both techniques will improve diagnosis in asymptomatic patients, allowing early therapeutic intervention and a better clinical outcome.
比较尿液样本的细胞学检查和免疫组织化学染色（IHS）对多瘤病毒再激活诊断的价值。
收集了18例免疫抑制患者的68份尿液样本，采用巴氏染色法和IHS法，使用JC/BK病毒特异性单克隆抗体进行分析。
总体而言，18例患者中有11例（61.1%）多瘤病毒BK（BKV）呈阳性（其中3例发生出血性膀胱炎），68份尿液样本中有23份（28%）呈阳性。在23份样本中，仅2种技术中的1种检测呈阳性的有4份（17%）。在23份样本中，两种方法均呈阳性的有19份（83%）。在同一患者匹配的尿液样本中，IHS法在尿涂片上检测到的BKV感染阳性细胞数量高于巴氏染色法（71.3%）。
IHS的主要优点是能够在尿液样本中确诊BKV感染。IHS在尿路上皮细胞阳性较少的样本中检测到更多BKV感染细胞，如果仅将巴氏染色法用作BKV筛查方法，这些细胞可能无法被检测到。采用两种技术对尿液样本进行BKV检测将改善无症状患者的诊断，实现早期治疗干预并获得更好的临床结果。
