荧光原位杂交技术检测沙眼衣原体的可行性研究

THE RELIABILITY OF DETECTING CHLAMYDIA TRACHOMATIS WITH FLUORESCENCE IN SITU HYBRIDIZATION

目的:探讨荧光原位杂交(FISH)技术检测沙眼衣原体(CT)的临床应用及其意义。方法:将超高倍多媒体显微仪检测法(MMDI)和荧光定量PCR结果一致作为判定衣原体是否感染的扩大金标准,取符合扩大金标准判定的宫颈棉拭子标本纳入FISH技术检测。结果:130例样本中MMDI和荧光定量PCR检测均为CT阳性的有52例,CT阴性的有78例。FISH技术检测阳性的46例,阴性84例。FISH技术检测CT的灵敏度为84.62%,特异度为97.44%,阳性预测值为95.65%,阴性预测值为90.48%。结论:成功构建了FISH技术检测沙眼衣原体的技术平台,该技术弥补了MMDI特异性低及PCR可视性不足的缺点。

Objective：To establish a technology platform with fluorescence in situ hybridization （FISH） to detect Chlamydia Trachomatis（CT）. The sensitivity and specificity of the FISH assay were compared with those of the polymerase chain reaction （PCR） using primers and multimedia microsopy diagnostic instrument （MMDI）. Methods： We used MMDI and PCR to detect the smear of cervical secretions. A total of 130 specimens with consistent result of MMDI and PCR （the expanded gold standard） had been found and then all of them were detected by FISH. The morphologic detection meaning was also discussed between these methods. Results： In 130 MMDI specimens, MMDI and PCR detecting showed 52 CT positive cases, 78 negative specimens. When they were detected by FISH, the results showed 46 positive cases and 84 negative cases. Results of expanded gold standard and FISH were consistent in 120 of the 130 samples （R= 0. 92）. Ten samples showed discordant results. The sensitivity and specificity of FISH were 84. 62% and 97.44%, respectively. The positive and negative predictive values were 95.65% and 90.48%, respectively. Conclusion： The application of FISH on screening CT infections can compensate the shortcomings of MMDI and PCR which are low specificity or lack of visibility.