Garady C, Saieg M A, Ko H M, Geddie W R, Boerner S L, da Cunha Santos G
Laboratory Medicine Program, University Health Network, Toronto, ON, Canada.
Cytopathology. 2014 Apr;25(2):101-7. doi: 10.1111/cyt.12073. Epub 2013 Jun 3.
Detection of Epstein-Barr virus (EBV) status might help in the diagnosis of EBV-related neoplasms. The rate of successful assays for the detection of EBV-infected cells in cytological preparations has not been fully explored. Our aims were to examine the rate of successful in situ hybridization (ISH) assays for EBV-encoded RNA (EBER) in cytological specimens and to explore reasons for failure.
An electronic search selected cases with ISH-EBER assays performed on cytological preparations during a 10-year period. Data regarding patient age, gender and immune status, sample type and site, type of preparation, ISH-EBER results, immunophenotyping and immunohistochemistry results, final diagnosis and correspondent histopathological samples were retrieved.
Sixty specimens from 58 patients with diagnoses of lymphoproliferative disorder (n = 35), carcinoma (n = 24) and sarcoma (n = 1) were identified. ISH-EBER assays were performed on 50 cell block sections and on 10 cytospin preparations, with 22 positive and 32 negative results. Six tests (four cytospins and two cell block sections) failed owing to loss of material during the assay and background staining, with an overall failure rate of 10% and 4% if cytospins were excluded. Assays were performed on 13 cytology and surgical specimens from the same site, with only one discrepant result.
Cell block sections had more successful ISH-EBER assays when compared with cytospins. Reasons for failure were loss of material on the slide and background staining. A high concordance rate with surgical specimens emphasizes the usefulness of cytological samples for determining EBV status in patients with exhausted or no histological material available.
检测爱泼斯坦-巴尔病毒（EBV）状态可能有助于EBV相关肿瘤的诊断。细胞学标本中检测EBV感染细胞的成功检测率尚未得到充分研究。我们的目的是检查细胞学标本中EBV编码RNA（EBER）原位杂交（ISH）检测的成功率，并探讨失败原因。
通过电子检索，选取在10年期间对细胞学标本进行ISH-EBER检测的病例。检索患者年龄、性别和免疫状态、样本类型和部位、制片类型、ISH-EBER结果、免疫表型和免疫组化结果、最终诊断及相应组织病理学样本等数据。
共鉴定出58例患者的60份标本，诊断包括淋巴增殖性疾病（n = 35）、癌（n = 24）和肉瘤（n = 1）。对50个细胞块切片和10个细胞涂片进行了ISH-EBER检测，结果为22例阳性和32例阴性。6次检测（4次细胞涂片和2次细胞块切片）因检测过程中材料丢失和背景染色而失败，如果排除细胞涂片，总体失败率为10%，细胞涂片的失败率为4%。对来自同一部位的13份细胞学和手术标本进行了检测，只有1例结果不一致。
与细胞涂片相比，细胞块切片的ISH-EBER检测成功率更高。失败原因是玻片上材料丢失和背景染色。与手术标本的高一致性率强调了细胞学样本在确定无可用组织学材料或组织学材料耗尽患者的EBV状态方面的有用性。
