Epstein-Barr virus (EBV)-encoded RNA: automated in-situ hybridization (ISH) compared with manual ISH and immunohistochemistry for detection of EBV in pediatric lymphoproliferative disorders

Pediatr Dev Pathol. 2009 May-Jun;12(3):195-9. doi: 10.2350/07-07-0316.1.

Abstract

Detection of Epstein-Barr virus (EBV) may be achieved by various methods, including EBV-encoded RNA (EBER) in-situ hybridization (ISH) and immunohistochemistry (IHC) for latent membrane protein (LMP-1). We compared novel automated ISH and IHC techniques in pediatric lymphoproliferative disorders with results obtained by manual ISH. Thirty-seven pediatric cases previously studied by manual EBER ISH (including 18 EBER-positive, 15 EBER-negative, and 4 EBER-equivocal cases) were used for the study. Automated EBER ISH and automated LMP-1 IHC were performed using the BondMax autostainer and prediluted EBER probe and EBV cell surface 1 to 4 at 1:50 dilution, respectively. Results of each of the automated techniques for EBV detection were compared with results by manual EBER ISH. Compared with manual EBER ISH as the gold standard, automated ISH had a sensitivity and specificity of 94% and 69%, respectively, accuracy of 83%, positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 90%. Automated IHC had a sensitivity of 44%, specificity of 93%, accuracy of 67%, PPV of 88%, and NPV of 59%. Automated ISH and IHC correlated significantly (P < 0.045). Automated ISH is useful for diagnosis of EBV-related pediatric neoplasms, being easy to perform and interpret and requiring only the technologist's time to set up and having a high sensitivity and NPV The automated IHC protocol is of too low sensitivity for routine use, although results show high specificity and PPV.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / virology
  • Epstein-Barr Virus Nuclear Antigens / genetics
  • Epstein-Barr Virus Nuclear Antigens / isolation & purification*
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immunohistochemistry / economics
  • Immunohistochemistry / methods*
  • In Situ Hybridization / economics
  • In Situ Hybridization / methods*
  • Lymphoproliferative Disorders / diagnosis*
  • Lymphoproliferative Disorders / virology
  • Organ Transplantation / adverse effects
  • Postoperative Complications
  • Predictive Value of Tests
  • RNA, Viral / isolation & purification
  • RNA, Viral / metabolism
  • Reproducibility of Results
  • Viral Matrix Proteins / genetics

Substances

  • EBV-associated membrane antigen, Epstein-Barr virus
  • Epstein-Barr Virus Nuclear Antigens
  • Epstein-Barr virus encoded RNA 1
  • RNA, Viral
  • Viral Matrix Proteins