定量PCR检测在恶性血液病患者合并侵袭性真菌感染早期诊断中的意义  

Quantitative PCR for Early Diagnosis of Invasive Fungal Infections in Patients with Hematologic Malignancies

作　　者：刘淑娟[1] 王欣[1] 王相华[1] 周海[1] 袁代[1] 姜华[1] 

机构地区：[1]山东大学附属省立医院血液科,山东济南250021

出　　处：《中国实验血液学杂志》2012年第5期1225-1230,共6页Journal of Experimental Hematology

基　　金：山东省科技发展计划项目(编号2008GG2NS102018)

摘　　要：为探讨定量PCR在恶性血液病患者合并侵袭性真菌感染诊断中的应用价值,分别对40例恶性血液病患者血清中的真菌DNA进行定量PCR测定并结合半乳甘露聚糖(GM)试验及相关临床检查进行实验研究。选取烟曲霉菌高度保守的28S rRNA区段序列为目的基因设计引物和探针,提取患者血清中真菌DNA进行定量PCR检测。测定结果表明:定量PCR检测敏感性为0.89,特异性为0.85,阳性预测值为0.89,阴性预测值为0.85;GM检测敏感性为0.83,特异性为0.80,阳性预测值为0.88,阴性预测值为0.73;联合应用定量PCR和GM检测,其中1项为阳性或2项均为阳性的敏感性为0.94,特异性为0.85,阳性预测值0.89,阴性预测值0.92。结论:真菌定量PCR试验可应用于恶性血液病患者侵袭性真菌感染的诊断,与GM试验联合应用可提高诊断敏感性。This study was aimed to establish the approach of quantitative PCR（q-PCR） for diagnosis of invasive fungal infections（IFI） in patients with hematologic malignancies.Specimens from 40 patients with hematologic malignancies were chosen for q-PCR and galactomannan（GM） test.The 28S rRNA,a real high consensus sequence of fungi,was selected as target gene to design primer and probe.The DNA of fungal species was extracted from serum specimens.The results showed that q-PCR sensitivity,specificity,positive and negative predictive values were 0.89,0.85,0.89,0.85 respectively;GM test sensitivity,specificity,positive and negative predictive values were 0.83,0.80,0.88,0.73 respectively;as combined q-PCR with GM test,these values were 0.94,0.85,0.89,0.92 respectively.It is concluded that the q-PCR assay can be used for early diagnosis for IFI in patients with hematologic malignancies,q-PCR combined with GM test can enhance the diagnosis sensitivity for IFI.

关 键 词：侵袭性真菌感染 恶性血液系统疾病 定量PCR GM检测 

分 类 号：R733[医药卫生—肿瘤] R519[医药卫生—临床医学]