Fritzsche Florian R, Pianca Silvio, Gaspert Ariana, Varga Zsuzsanna, Wang Lin, Farrell Michael P, Chen Xiao-Bo, Hirsch Hans H, Springer Erik, Fehr Thomas, Myles Jonathan, Tubbs Raymond, Moch Holger
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
Diagn Mol Pathol. 2011 Jun;20(2):105-10. doi: 10.1097/PDM.0b013e3182015074.
BK virus nephropathy is not an infrequent complication of renal transplantation associated with high rates of graft loss. Although antibodies against SV40 antigen detect different viruses of the polyomavirus family, immunohistochemistry is widely used to confirm the diagnosis of BK virus nephropathy in renal biopsies. Here we aimed to validate the novel silver-enhanced in situ hybridization (SISH) technique for the automated detection of BK virus in renal transplant biopsies. Two different patient cohorts were included. Twenty-nine consecutive patients suspicious for BK virus infection were investigated by SISH and chromogenic in situ hybridization. An additional 26 renal biopsies positive by SV40 immunohistochemistry from 19 patients were analyzed by SISH. Polyomavirus DNA serum levels, as determined by nested PCR analysis, were available for all of these patients. The presence of BK virus DNA in renal tubular cells was identified in 5 of the suspicious cases by both, SISH and chromogenic in situ hybridization . One additional patient was only positive in the SISH. In the second cohort, SISH was positive in all SV40 positive biopsies, but SISH signals were less extensive than SV40 immunohistochemistry. Our results show that the BK virus SISH is an ancillary tool for the detection of polyomavirus DNA in renal biopsies using bright-field microscopy. However, its diagnostic value in comparison with standard immunohistochemistry seems to be limited.
BK病毒肾病是肾移植中一种并不罕见的并发症，与高移植肾丢失率相关。尽管针对SV40抗原的抗体可检测多瘤病毒科的不同病毒，但免疫组化在肾活检中被广泛用于确诊BK病毒肾病。在此，我们旨在验证新型银增强原位杂交（SISH）技术用于肾移植活检中BK病毒的自动检测。纳入了两个不同的患者队列。通过SISH和显色原位杂交对连续29例疑似BK病毒感染的患者进行了研究。另外对19例患者的26份经SV40免疫组化呈阳性的肾活检组织进行了SISH分析。所有这些患者均通过巢式PCR分析测定了多瘤病毒DNA血清水平。在5例疑似病例中，通过SISH和显色原位杂交均在肾小管细胞中鉴定出BK病毒DNA。另有1例患者仅SISH呈阳性。在第二个队列中，所有SV40阳性活检组织的SISH均呈阳性，但SISH信号范围小于SV40免疫组化。我们的结果表明，BK病毒SISH是一种使用明场显微镜检测肾活检中多瘤病毒DNA的辅助工具。然而，与标准免疫组化相比，其诊断价值似乎有限。
