Department of Medical Microbiology, Bursa Uludag University Hospital, Bursa 16120, Turkey.
Department of Gastroenterology, Bursa Uludag University Hospital, Bursa 16120, Turkey.
Viruses. 2024 Apr 26;16(5):691. doi: 10.3390/v16050691.
Cytomegalovirus (CMV) colitis is a critical condition associated with severe complications in ulcerative colitis (UC). This study aimed to investigate the diagnostic value of the presence of CMV DNA in intestinal mucosa tissue and blood samples in patients with active UC. This study included 81 patients with exacerbated symptoms of UC. Patient data were obtained from the Hospital Information Management System. CMV DNA in colorectal tissue and plasma samples were analyzed using a real-time quantitative PCR assay. CMV markers were detected using immunohistochemistry and hematoxylin-eosin staining. Immunohistochemistry positivity was observed in tissue samples from eight (9.9%) patients. Only one (1.2%) patient showed CMV-specific intranuclear inclusion bodies. CMV DNA was detected in 63.0% of the tissues (median: 113 copies/mg) and in 58.5% of the plasma samples (median: 102 copies/mL). For tissues, sensitivity and the negative predictive value (NPV) for qPCR were excellent (100.0%), whereas specificity and the positive predictive value (PPV) were low (41.9% and 15.7%, respectively). For plasma, sensitivity and NPV were high (100.0%) for qPCR, whereas specificity and PPV were low (48.6% and 24.0%, respectively). CMV DNA ≥392 copies/mg in tissue samples (sensitivity 100.0% and specificity 83.6%) and ≥578 copies/mL (895 IU/mL) in plasma samples (sensitivity 66.7% and specificity 100.0%) provided an optimal diagnosis for this test. The qPCR method improved patient management through the early detection of CMV colitis in patients with UC. However, reliance on qPCR positivity alone can lead to overdiagnosis. Quantification of CMV DNA can improve diagnostic specificity, although standardization is warranted.
巨细胞病毒（CMV）结肠炎是溃疡性结肠炎（UC）严重并发症相关的危急情况。本研究旨在探讨在活动期 UC 患者的肠黏膜组织和血液样本中存在 CMV DNA 的诊断价值。本研究纳入 81 例 UC 症状加重的患者。患者数据来自医院信息管理系统。使用实时定量 PCR 检测法分析结直肠组织和血浆样本中的 CMV DNA。使用免疫组织化学和苏木精-伊红染色检测 CMV 标志物。组织样本中观察到 8 例（9.9%）患者免疫组织化学阳性。仅有 1 例（1.2%）患者出现 CMV 特异性核内包涵体。组织中 CMV DNA 的检出率为 63.0%（中位数：113 拷贝/mg），血浆样本中 CMV DNA 的检出率为 58.5%（中位数：102 拷贝/mL）。组织中 qPCR 的敏感性和阴性预测值（NPV）均为 100.0%，特异性和阳性预测值（PPV）较低（分别为 41.9%和 15.7%）。血浆中 qPCR 的敏感性和 NPV 均较高（100.0%），特异性和 PPV 较低（分别为 48.6%和 24.0%）。组织样本中 CMV DNA≥392 拷贝/mg（敏感性 100.0%，特异性 83.6%）和血浆样本中 CMV DNA≥578 拷贝/mL（895 IU/mL）（敏感性 66.7%，特异性 100.0%）的检测结果为阳性时，该检测方法具有最佳诊断效果。qPCR 方法通过早期检测 UC 患者的 CMV 结肠炎，改善了患者的管理。然而，仅依赖 qPCR 阳性结果可能导致过度诊断。CMV DNA 的定量检测可以提高诊断的特异性，尽管需要标准化。
