Arai Yasuyuki, Kondo Tadakazu, Kitano Toshiyuki, Hishizawa Masakatsu, Yamashita Kouhei, Kadowaki Norimitsu, Takaori-Kondo Akifumi
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University.
Rinsho Ketsueki. 2014 Dec;55(12):2400-7. doi: 10.11406/rinketsu.55.2400.
Gastro-intestinal cytomegalovirus infection (GI-CMV), which occurs after allogeneic stem cell transplantation (allo-SCT), is diagnosed by immunostaining of biopsied tissues obtained using a fiberscope. However, the sensitivity of this pathological diagnostic test is poor. We evaluated the suitability of using quantitative polymerase chain reaction (qPCR) to test GI-mucosal tissues for CMV. We analyzed adult patients who had undergone allo-SCT at our institute. Twenty-seven specimens were collected from patients undergoing GI-fibers-copy for upper GI-symptoms after allo-SCT. Of these patients, 9 tested positive for CMV by qPCR; their symptoms resolved soon after receiving antiviral therapies for CMV. Pathological procedures detected GI-CMV in only 3 cases. In contrast, CMV qPCR was positive for 12 of 30 specimens collected from patients with lower GI-symptoms by using colon fibers-copy. Antiviral therapies were effective in all but one case. GI-CMV was diagnosed pathologically in only 5 cases. Therefore, CMV qPCR is effective for early therapeutic intervention in CMV-GI patients after allo-SCT.
胃肠道巨细胞病毒感染（GI-CMV）发生在异基因造血干细胞移植（allo-SCT）之后，通过对使用纤维内镜获取的活检组织进行免疫染色来诊断。然而，这种病理诊断测试的敏感性较差。我们评估了使用定量聚合酶链反应（qPCR）检测GI黏膜组织中巨细胞病毒的适用性。我们分析了在我院接受allo-SCT的成年患者。从allo-SCT后出现上消化道症状而接受GI纤维内镜检查的患者中收集了27份标本。在这些患者中，9例通过qPCR检测出巨细胞病毒呈阳性；他们在接受抗巨细胞病毒抗病毒治疗后症状很快缓解。病理检查仅在3例中检测到GI-CMV。相比之下，从因下消化道症状接受结肠纤维内镜检查的患者中收集的30份标本中，有12份巨细胞病毒qPCR呈阳性。除1例患者外，抗病毒治疗在所有病例中均有效。病理诊断仅在5例中确诊为GI-CMV。因此，巨细胞病毒qPCR对于allo-SCT后巨细胞病毒感染的胃肠道患者的早期治疗干预是有效的。
