EB 病毒 DNA 载量在 EB 病毒相关性疾病中的临床应用：一项队列研究。

Clinical application of Epstein-Barr virus DNA loads in Epstein-Barr virus-associated diseases: A cohort study.

机构信息

Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.

Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

J Infect. 2021 Jan;82(1):105-111. doi: 10.1016/j.jinf.2020.11.027. Epub 2020 Nov 26.

DOI:10.1016/j.jinf.2020.11.027

PMID:33248217

Abstract

OBJECTIVES

This study evaluated the diagnostic value of Epstein-Barr virus (EBV) DNA load in blood samples of patients with EBV-associated diseases, and proposed a strategy for the interpretation of positive EBV DNA results.

METHODS

Derivation and validation cohorts were established to evaluate the clinical significance of EBV DNA loads in the peripheral blood mononuclear cells (PBMCs) and plasma from EBV-infected patients. EBV DNA loads were compared and receiver operating characteristic curves were employed to assess the optimal cutoff values of EBV DNA for identification of EBV-associated diseases.

RESULTS

The derivation and validation cohorts comprised 135 and 71 subjects, respectively. EBV DNA loads in the PBMCs of the EBV-associated diseases group was significantly higher than that of the EBV non-associated diseases group (5.8 × 10 vs 7.8 × 10 copies/10 cells, P<0.0001). The diagnostic cut-off value of viral load in PBMCs for EBV-associated diseases was determined to be 1.6 × 10 copies/10 cells. The combined EBV DNA load cutoff in PBMCs and positive EBV DNA qualitative detection in plasma (>500 copies/mL) allowed for the differentiation of EBV-associated and non-associated diseases; the sensitivity and specificity were 80.6 and 96.8%, respectively.

CONCLUSIONS

The strategy of combining EBV DNA loads in PBMCs and plasma will potentially help identify EBV-associated diseases.

摘要

目的

本研究评估了血液样本中 EBV 病毒（EBV）DNA 载量在 EBV 相关疾病患者中的诊断价值，并提出了一种解释 EBV DNA 阳性结果的策略。

方法

建立了验证队列，以评估 EBV 感染患者外周血单个核细胞（PBMC）和血浆中 EBV DNA 载量的临床意义。比较 EBV DNA 载量，并采用受试者工作特征曲线评估 EBV DNA 用于识别 EBV 相关疾病的最佳截断值。

结果

验证队列包括 135 例和 71 例患者。EBV 相关疾病组 PBMCs 中的 EBV DNA 载量明显高于 EBV 非相关疾病组（5.8×10 拷贝/10 细胞对 7.8×10 拷贝/10 细胞，P<0.0001）。用于诊断 EBV 相关疾病的 PBMCs 中病毒载量的诊断截断值确定为 1.6×10 拷贝/10 细胞。联合 PBMCs 中 EBV DNA 载量和血浆中阳性 EBV DNA 定性检测（>500 拷贝/mL）可区分 EBV 相关和非相关疾病；其敏感性和特异性分别为 80.6%和 96.8%。