Sensitivity and specificity of immunohistochemistry for the diagnosis of filamentous fungal infections.

IF 2.3 4区医学 Q2 PATHOLOGY

American journal of clinical pathology Pub Date : 2025-05-10 DOI:10.1093/ajcp/aqaf037

Victoria L Thomas, Alvaro C Laga, Isaac H Solomon

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引用次数: 0

Abstract

Objectives: Many fungal species share overlapping morphologic features in tissue sections, preventing reliable identification and optimal treatment. We sought to determine whether immunohistochemistry (IHC) using a panel of commercially available antibodies could effectively distinguish between fungi commonly encountered in anatomic pathology specimens.

Methods: Anti-Aspergillus, anti-Rhizopus, and anti-Candida IHC was performed on formalin-fixed, paraffin-embedded tissue sections from 24 cases with fungal infections identified by culture or sequencing (including 4 polyfungal infections).

Results: Anti-Aspergillus IHC was positive in 6 of 6 Aspergillus and focally in 1 of 4 Candida species infections and negative in all cases of Fusarium, Scedosporium, Rhizopus, and Mucor species, yielding overall sensitivity of 100% and specificity of 95%. Anti-Rhizopus IHC was positive in 4 of 4 Rhizopus and 1 of 3 Mucor species infections and negative in all other cases, with a sensitivity of 71% and a specificity of 100%. Anti-Candida IHC was positive in 4 of 4 Candida species infections and showed some cross-reactivity in all other cases, resulting in 100% sensitivity and 0% specificity.

Conclusions: Anti-Aspergillus IHC was highly sensitive and specific in its ability to distinguish Aspergillus from other similar-appearing hyaline molds, including Fusarium and Scedosporium species. Anti-Rhizopus IHC was moderately sensitive and highly specific, while anti-Candida IHC was highly sensitive but had minimal specificity.

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免疫组织化学诊断丝状真菌感染的敏感性和特异性。

目的：许多真菌物种在组织切片上具有重叠的形态特征，妨碍了可靠的鉴定和最佳的治疗。我们试图确定使用一组市售抗体的免疫组织化学（IHC）是否可以有效区分解剖病理标本中常见的真菌。方法：对24例经培养或测序鉴定的真菌感染（其中4例为多真菌感染）进行福尔马林固定石蜡包埋组织切片，进行抗曲霉、抗根霉和抗念珠菌免疫组化。结果：抗曲霉IHC在6种曲霉中6种呈阳性，在4种念珠菌中1种呈局灶性阳性，在镰刀菌、丝孢菌、根霉和毛霉菌中全部呈阴性，总体敏感性为100%，特异性为95%。抗根霉免疫组化检测在4种根霉感染和3种毛霉感染中分别有4种和1种呈阳性，其余均为阴性，敏感性为71%，特异性为100%。抗念珠菌IHC在4种念珠菌感染中4种呈阳性，其余病例均有交叉反应，敏感性为100%，特异性为0%。结论：Anti-Aspergillus IHC在区分曲霉与其他外观相似的透明霉菌（包括Fusarium和sedosporium）方面具有高度的敏感性和特异性。抗根霉免疫组化具有中等敏感性和高特异性，而抗念珠菌免疫组化具有高敏感性和低特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of clinical pathology 医学-病理学

CiteScore

7.70

自引率

2.90%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The American Journal of Clinical Pathology (AJCP) is the official journal of the American Society for Clinical Pathology and the Academy of Clinical Laboratory Physicians and Scientists. It is a leading international journal for publication of articles concerning novel anatomic pathology and laboratory medicine observations on human disease. AJCP emphasizes articles that focus on the application of evolving technologies for the diagnosis and characterization of diseases and conditions, as well as those that have a direct link toward improving patient care.