Alain S, Lachaise V, Hantz S, Denis F
Centre national de référence des cytomégalovirus, CHU de Limoges, 2, avenue M.-L.-King, 87000 Limoges, France.
Pathol Biol (Paris). 2010 Apr;58(2):156-61. doi: 10.1016/j.patbio.2009.08.003. Epub 2009 Oct 28.
The broad use of cytomegalovirus (CMV) viral load quantification in blood to follow immunosuppressed patients need standardized assays. Choice of whole blood allows follow-up for several viruses and simplifies pretreatment and storage of samples.
We therefore evaluated the LightCycler CMV Quant Kit (Roche Diagnostics) assay on whole blood after a manual extraction (High Pure viral nucleic acid kit, Roche Diagnostics), using as a reference an in-house Taqman assay (LC1UL83) which has been validated in various clinical situations. A panel obtained by serial dilutions of a virion stock in CMV whole blood, a commercial plasma quality control (VQC, Argène, France) crude or diluted in whole blood, infected cells extracts and 46 clinical samples from transplanted patients were tested simultaneously by both techniques.
For plasma quality controls, both PCR assays are correlated VQC (R(2)=0.93). On whole blood or infected cells dilutions, correlation shows an overestimation by the LC1UL83 assay (mean 1.2 log copies/ml) over 3 log though R(2)=0.94. Results with CMV Quant Kit are closer to expected values. Results on clinical samples are close to quality controls with a lower variation of quantification (0.76 log copies/ml).
CMV Quant Kit performs well when compared with a clinically validated PCR. Quality control results showed discrepancies between plasma and whole blood, demonstrating the need for whole blood standardized panels to compare the methods. This underlines the need to follow a patient with the same technique during his follow-up.
在对免疫抑制患者进行随访时,广泛使用血液中的巨细胞病毒(CMV)病毒载量定量检测需要标准化的检测方法。选择全血可对多种病毒进行随访,并简化样本的预处理和储存。
因此,我们在手动提取(罗氏诊断公司的高纯病毒核酸试剂盒)后,对全血中的LightCycler CMV定量试剂盒(罗氏诊断公司)检测方法进行了评估,使用内部Taqman检测方法(LC1UL83)作为参考,该方法已在各种临床情况下得到验证。通过在CMV全血中对病毒粒子储备液进行系列稀释获得的一组样本、一种商业血浆质量控制品(VQC,法国阿让公司),其原液或在全血中稀释后的样本、感染细胞提取物以及46例来自移植患者的临床样本,同时用这两种技术进行检测。
对于血浆质量控制品,两种PCR检测方法与VQC均具有相关性(R² = 0.93)。在全血或感染细胞稀释样本中,尽管R² = 0.94,但相关性显示LC1UL83检测方法在超过3个对数时存在高估(平均高估1.2 log拷贝/毫升)。CMV定量试剂盒的结果更接近预期值。临床样本的结果与质量控制品接近,定量变异较低(0.76 log拷贝/毫升)。
与经过临床验证的PCR相比,CMV定量试剂盒表现良好。质量控制结果显示血浆和全血之间存在差异,表明需要全血标准化样本组来比较这些方法。这突出了在患者随访期间需要使用相同技术进行跟踪的必要性。