摘要
目的比较多重荧光PCR-熔解曲线法与病理诊断法检测福尔马林固定石蜡包埋(FFPE)肺组织样本中病原真菌的价值。方法选择2014—2019年本院病理科病原真菌阳性患者的42份肺组织样本(念珠菌8份、曲霉菌23份、隐球菌11份)作为阳性组,病原真菌阴性的肺组织样本50份作为阴性组,均进行多重荧光PCR-熔解曲线法检测,并应用配对χ2检验和Kappa值对两种方法的检测结果进行比较。结果阳性组42份样本多重荧光PCR-熔解曲线法检出23份阳性,并可分辨至种水平,其中念珠菌4份(白色念珠菌2份、热带念珠菌1份、克柔念珠菌1份)、曲霉菌13份(烟曲霉11份、黄曲霉2份)、新型隐球菌6份。阴性组50份样本多重荧光PCR-熔解曲线法检测均阴性。Kappa值0.568,以病理诊断法为"金标准",多重荧光PCR-熔解曲线法检测病原真菌的灵敏度为54.8%(23/42)、特异性为100.0%(50/50)。结论多重荧光PCR-熔解曲线法检测FFPE样本中病原真菌的灵敏度不高,但可以将病原真菌鉴定至种,是病理诊断法的补充。
Objective To compare the diagnostic value of multiplex fluorescent PCR melting curve method and pathological diagnosis for pathogenic fungi in formalin-fixed paraffin-embedded(FFPE)lung tissue specimens.Methods A total of 42 pathological fungi-positive lung tissue FFPE specimens(8 samples of Candida,23 samples of Aspergillus and 11 samples of Cryptococci)were selected as positive group and 50 samples of pathological fungi-negative lung tissue FFPE specimens were selected as negative group in our hospital from 2014 to 2019.All these lung tissue FFPE specimens were detected by multiplex fluorescent PCR melting curve method,and the results of two diagnosis method were compared by paired chi-square test and Kappa value.Results There were 23 samples positive detected by multiplex fluorescent PCR melting curve method in positive group,including 4 samples of Candida spp(2 samples of Candida albicans,1 sample of Candida tropicalis and 1 sample of Candida krusei),13 samples of Aspergillus spp(11 samples of Aspergillus fumigatus,2 samples of Aspergillus flavus)and 6 samples of Cryptococcus neoformans.There were 50 samples negative detected by multiplex fluorescent PCR melting curve method in negative group.Paired chi-square test showed that the results of two methods were significantly different(P<0.01).The Kappa value was 0.568,which illustrated the consistency of the two methods was common.The pathological diagnosis was served as the golden standard for the diagnosis of fungal infections,the sensitivity and specificity of multiplex fluorescent PCR melting curve method for detecting pathogenic fungi were 54.8%(23/42)and 100.0%(50/50),respectively.Conclusions The sensitivity of multiplex fluorescent PCR melting curve method to detect pathogenic fungi in FFPE specimens is lower than that of pathological diagnosis,but it can identify pathogenic fungi to species level,which is a supplement to pathological diagnosis.
作者
朱芳
朱以军
翟晓利
胡益飞
倪红英
Zhu Fang;Zhu Yijun;Zhai Xiaoli;Hu Yifei;Ni Hongying(Department of Pathology,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China;Clinical Laboratory,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China;Department of Intensive Care Medicine,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China)
出处
《国际流行病学传染病学杂志》
CAS
2020年第1期50-54,共5页
International Journal of Epidemiology and Infectious Disease
基金
浙江省公益技术应用研究分析测试计划(2017C37050)
金华市中心医院中青年科研启动基金(JY2016-2-03)。
