JC 病毒 PCR 在脑脊液中对 PML 的诊断价值。
Predictive value of JC virus PCR in cerebrospinal fluid in the diagnosis of PML.
机构信息
Neurology Department, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology and Leuven Brain Institute (LBI), Leuven, Belgium; VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium.
Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
出版信息
Diagn Microbiol Infect Dis. 2019 Nov;95(3):114859. doi: 10.1016/j.diagmicrobio.2019.06.011. Epub 2019 Jun 26.
OBJECTIVE
To assess the predictive value of JC virus (JCV) PCR in cerebrospinal fluid (CSF) in the diagnosis of progressive multifocal leukoencephalopathy (PML).
METHODS
We conducted a retrospective database query to identify patients with positive CSF JCV PCR. Clinical features, final diagnosis and quantitative PCR results were obtained.
RESULTS
A positive CSF JCV PCR had a PPV of 10.4% for the diagnosis of PML. A weakly positive PCR had a PPV of 1.6%, whereas a moderately to highly positive PCR had a PPV of 92.3%. A PPV of 0.0% was observed in immunocompetent patients and in patients without compatible clinical or radiological features.
CONCLUSIONS
A false-positive CSF JCV PCR is highly prevalent in our clinical practice. This test should be reserved for patients with a clinical suspicion of PML and the quantitative result of the PCR should be taken into account when making the diagnosis of PML.
目的
评估脑脊液（CSF）中 JC 病毒（JCV）PCR 在诊断进行性多灶性白质脑病（PML）中的预测价值。
方法
我们进行了回顾性数据库查询，以确定 CSF JCV PCR 阳性的患者。获取了临床特征、最终诊断和定量 PCR 结果。
结果
CSF JCV PCR 阳性对 PML 的诊断的阳性预测值（PPV）为 10.4%。弱阳性 PCR 的 PPV 为 1.6%，而中度至高度阳性 PCR 的 PPV 为 92.3%。在免疫功能正常的患者和无相关临床或影像学特征的患者中，观察到的 PPV 为 0.0%。
结论
在我们的临床实践中，假阳性 CSF JCV PCR 非常普遍。该检测应保留用于临床疑似 PML 的患者，并且在诊断 PML 时应考虑 PCR 定量结果。
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