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基于免疫印迹法检测爱泼斯坦-巴尔病毒衣壳抗体的分析评估

[Evaluation of immunoblot-based assay for detecting Epstein-Barr virus viral capsid antibodies].

作者信息

Altuğlu Imre, Aksoy Ayşegül, Zeytinoğlu Ayşin, Orman Mehmet

机构信息

Ege Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dahli, Izmir.

出版信息

Mikrobiyol Bul. 2010 Apr;44(2):231-6.

Abstract

Various attempts have been made to improve Epstein-Barr virus (EBV) serodiagnosis by developing more practical and objective methods than immunofluorescence-based assays. In the present study, the performance of immunoblot-based assays were evaluated by comparing the results obtained by the gold standard immunofluorescence antibody (IFA) test for the detection of IgM and IgG antibodies against EBV viral capsid antigen (anti-VCA). Serum samples of 277 patients admitted to Ege University Hospital for routine EBV diagnosis were included in the study. The age range of the patients was 3 months-89 years (mean 28 years) and 104 of them were females and 173 were males. All the samples were assayed by commercial immunoblot (Euroline IgM and IgG; Euroimmun, Germany) and IFA (EBV-CA IgG and IgM, Euroimmun, Germany) methods. Crosstabulation, chi-square test and phi (phi) measures in SPSS 16.0 statistical package programme were used for data analysis. Of the 216 samples that were interpreted as positive with immunoblot-based IgM assay, only 34 (15.7%) were confirmed as positive with IFA, whereas 162 (75%) were negative, and 20 (9.3%) were equivocal (phi = 0.167; low correlation). Of the 85 samples that were anti-VCA IgG positive with immunoblot assay, 82 (96.5%) were positive, 2 (2.3%) were negative and 1 (1.2%) were equivocal with IFA (phi = 0.441; significant correlation). When the indeterminate results obtained by IFA test were excluded from the evaluation, the correlation between immunoblot VCA IgG and IFA IgG was 85.4% (88/103) and between immunoblot VCA IgM and IFA IgM was 27.3% (69/253). When the intensities of bands were evaluated for IgM testing, it was noted that as the intensity of the bands increased (1+ to 3+), IFA VCA IgM reactivity rates increased (from 9.9% to 29.5% for p19 band; from 24% to 85.7% for gp125 band). For immunoblot VCA IgM testing, 165 samples were found to be positive only for VCA p19 band. Of these samples, 135 (81.8%) were negative, 15 (9.1%) were positive and 15 (9.1%) were equivocal with IFA. It is observed that even though immunoblot assays with automated blotting and scanning systems can be a convenient alternative to immunofluorescence assay, the rate of false positivity obtained for VCA IgM was high (75%). It was concluded that in laboratories which apply immunoblotting as a primary screening test for EBV serodiagnosis, the positive VCA IgM results (particularly isolated p19 band positivity) and the presence of low intensity bands, should be confirmed by IFA testing.

摘要

人们已进行了各种尝试,通过开发比基于免疫荧光的检测方法更实用、客观的方法来改进爱泼斯坦 - 巴尔病毒(EBV)血清学诊断。在本研究中,通过比较基于免疫印迹的检测方法与检测抗EBV病毒衣壳抗原(抗VCA)IgM和IgG抗体的金标准免疫荧光抗体(IFA)试验所获得的结果,对基于免疫印迹的检测方法的性能进行了评估。纳入了277例因常规EBV诊断入住伊兹密尔埃杰大学医院的患者的血清样本。患者年龄范围为3个月至89岁(平均28岁),其中104例为女性,173例为男性。所有样本均采用商用免疫印迹法(Euroline IgM和IgG;德国Euroimmun公司)和IFA法(EBV - CA IgG和IgM,德国Euroimmun公司)进行检测。使用SPSS 16.0统计软件包程序中的交叉表、卡方检验和phi(φ)测量进行数据分析。在基于免疫印迹的IgM检测中被判定为阳性的216份样本中,只有34份(15.7%)经IFA确认为阳性,162份(75%)为阴性,20份(9.3%)结果不明确(φ = 0.167;相关性低)。在免疫印迹检测中抗VCA IgG呈阳性的85份样本中,82份(96.5%)经IFA检测为阳性,2份(2.3%)为阴性,1份(1.2%)结果不明确(φ = 0.441;显著相关)。当将IFA试验获得的不确定结果排除在评估之外时,免疫印迹VCA IgG与IFA IgG之间的相关性为85.4%(88/103),免疫印迹VCA IgM与IFA IgM之间的相关性为27.3%(69/253)。在评估IgM检测的条带强度时,注意到随着条带强度增加(从1 +到3 +),IFA VCA IgM反应率增加(p19条带从9.9%增至29.5%;gp125条带从24%增至85.7%)。对于免疫印迹VCA IgM检测,发现165份样本仅VCA p19条带呈阳性。在这些样本中,135份(81.8%)经IFA检测为阴性,15份(9.1%)为阳性,15份(9.1%)结果不明确。据观察,尽管采用自动印迹和扫描系统的免疫印迹检测方法可能是免疫荧光检测的一种便捷替代方法,但VCA IgM检测获得的假阳性率较高(75%)。得出的结论是,在将免疫印迹法作为EBV血清学诊断的主要筛查试验的实验室中,VCA IgM阳性结果(特别是单独的p19条带阳性)以及低强度条带的存在,应通过IFA检测进行确认。

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