Liao Xiaoyan, Reed Sharon L, Lin Grace Y
Department of Pathology, University of California, San Diego, CA, USA.
Department of Pathology, University of California, San Diego, CA, USA; Department of Medicine, University of California, San Diego, CA, USA.
Gastroenterology Res. 2016 Dec;9(6):92-98. doi: 10.14740/gr725e. Epub 2016 Dec 23.
Cytomegalovirus (CMV) infection can be asymptomatic in healthy individuals but may cause serious complications in immunocompromised patients. We investigated the clinicopathological correlation of CMV in gastrointestinal (GI) biopsies at our institute between January 1, 2013 and December 31, 2015.
A total of 105 non-neoplastic GI biopsies tested positive for CMV by immunohistochemistry (IHC). The IHC results were stratified as "true positive" if > 2 cells stained, or "rare positive" if only 1 - 2 cells stained. Clinical information including comorbidities, serum CMV viral loads, and treatment was reviewed and correlated.
Overall 1% of all GI biopsies were positive for CMV by immunostaining. The most frequently involved organ was colon, followed by esophagus, stomach, ileum and duodenum. When > 2 cells were stained positive, serum CMV viral loads were positive in 52.2%, negative in 17.2%, and not tested in 27.6% of cases. When only 1 - 2 cells stained positive, CMV viral loads were positive in 23.4%, negative in 25.5%, and not tested in 51.1% of cases. We further showed that clinical management of CMV differs based on both pathological findings and underlying diseases.
The role of CMV in GI biopsies remains controversial. We propose an algorithm of performing CMV immunostaining based on clinicopathological correlation.
巨细胞病毒（CMV）感染在健康个体中可能无症状，但在免疫功能低下的患者中可能会引起严重并发症。我们调查了2013年1月1日至2015年12月31日期间我院胃肠道（GI）活检中CMV的临床病理相关性。
共有105例非肿瘤性GI活检经免疫组织化学（IHC）检测CMV呈阳性。如果>2个细胞染色，则IHC结果分层为“真阳性”；如果仅1-2个细胞染色，则为“罕见阳性”。回顾并关联了包括合并症、血清CMV病毒载量和治疗在内的临床信息。
总体而言，所有GI活检中有1%经免疫染色CMV呈阳性。最常受累的器官是结肠，其次是食管、胃、回肠和十二指肠。当>2个细胞染色呈阳性时，52.2%的病例血清CMV病毒载量呈阳性，17.2%呈阴性，27.6%未检测。当仅1-2个细胞染色呈阳性时，23.4%的病例CMV病毒载量呈阳性，25.5%呈阴性，51.1%未检测。我们进一步表明，CMV的临床管理因病理结果和基础疾病而异。
CMV在GI活检中的作用仍存在争议。我们提出了一种基于临床病理相关性进行CMV免疫染色的算法。
