Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Department of Gastroenterology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Turk J Gastroenterol. 2021 Feb;32(2):123-132. doi: 10.5152/tjg.2021.191008.
In Turkey, cytomegalovirus (CMV) seropositivity has been reported to be high, between 85 and 100%. CMV has been responsible for disease exacerbation in inflammatory bowel disease (IBD). We aimed to evaluate the presence of CMV in intestinal tissue by immunohistochemical staining in IBD and non-IBD patient groups, in a country with high CMV seroprevalence.
In this prospective cross-sectional study, the presence of intestinal CMV was investigated with tissue immunohistochemistry (IHC) staining, which is accepted as the gold standard method, and with polymerase chain reaction (PCR) in tissue and blood. Patients (≥18 years old, n = 189) who had a colonoscopic biopsy between January and May 2017 were included in the study at our hospital. Clinical, laboratory, endoscopic, and histopathological data of patients were assessed by dividing them into IBD (n = 34) and non-IBD (n = 155) groups.
In this study, 567 colonic biopsy samples from 189 patients were evaluated. Tissue IHC staining was positive for 3 (1.58%) non-IBD patients. One of them was diagnosed as CMV ileitis. CMV DNA was also detected in 14 plasma (7.40%, <80-469 copies/mL) and 20 tissue samples (10.69%, 7-15 289 copies/mL). Tissue IHC staining is accepted as the gold standard for CMV ileitis, and the sensitivity and specificity of tissue PCR was 33% and 89.67%, while the sensitivity and specificity of plasma PCR was 66.66% and 93.54%, respectively.
Although CMV seroprevalence is high in Turkey, CMV ileitis was diagnosed in only one non-IBD patient (0.53%). Compared to tissue IHC staining, the sensitivity of tissue and blood CMV PCR was low while their specificity was higher.
在土耳其，巨细胞病毒（CMV）血清阳性率报告高达 85%至 100%。CMV 已成为炎症性肠病（IBD）疾病恶化的原因。我们旨在评估在 CMV 血清阳性率较高的国家，通过免疫组织化学染色（IHC）在 IBD 和非 IBD 患者组中检测肠道组织中 CMV 的存在。
在这项前瞻性病例对照研究中，我们通过组织免疫组织化学（IHC）染色（被认为是金标准方法）以及组织和血液中的聚合酶链反应（PCR）来检测肠道 CMV 的存在。在我们医院，于 2017 年 1 月至 5 月期间进行结肠镜检查活检的患者（年龄≥18 岁，n=189）被纳入研究。通过将患者分为 IBD（n=34）和非 IBD（n=155）组，评估患者的临床、实验室、内镜和组织病理学数据。
在这项研究中，对 189 名患者的 567 个结肠活检样本进行了评估。3 名（1.58%）非 IBD 患者的组织 IHC 染色呈阳性。其中 1 名被诊断为 CMV 回肠炎。还在 14 份血浆（7.40%，<80-469 拷贝/mL）和 20 份组织样本（10.69%，7-15 289 拷贝/mL）中检测到 CMV DNA。组织 IHC 染色被认为是 CMV 回肠炎的金标准，组织 PCR 的敏感性和特异性分别为 33%和 89.67%，而血浆 PCR 的敏感性和特异性分别为 66.66%和 93.54%。
尽管土耳其的 CMV 血清阳性率较高，但仅在 1 名非 IBD 患者（0.53%）中诊断出 CMV 回肠炎。与组织 IHC 染色相比，组织和血液 CMV PCR 的敏感性较低，而特异性较高。
