首页|以ETV6/RUNX1探针为例探讨FISH性能验证方法

以ETV6/RUNX1探针为例探讨FISH性能验证方法

Use of the ETV6/RUNX1 probe to verify the performance of the fluorescence in situ hybridization probe before clinical detection

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目的 探讨FISH探针应用于临床检测前的规范化性能验证.方法 选取20名正常供者检测后剩余的骨髓样本进行间期细胞和中期分裂象FISH杂交,分析ETV6/RUNX1探针的灵敏度和特异性.采用反β函数建立该探针的阈值体系,并制定判读标准.最后以PCR检测为对照组,对286例中国医学科学院血液病医院患者骨髓样本进行平行对照研究,分析ETV6/RUNX1探针FISH检测的临床敏感性、特异性、诊断符合率,并采用Kappa检验分析两种方法诊断一致性.结果ETV6/RUNX1探针灵敏度为98.47%,特异性为100%.计数50、100和200个细胞时经典阳性信号阈值分别为5.81%、2.95%和1.49%,非经典阳性信号阈值分别为13.98%、9.75%和6.26%.FISH检测临床敏感性为96.1%,特异性为99.6%,诊断符合率为99.00%,诊断一致性检验Kappa值为0.964,P值<0.001.结论 不具备国家医疗器械注册证的商品化FISH探针,可通过实验室自建方法验证标准进行探针的规范化性能验证和方法学性能确认,以保证为临床诊疗提供可靠、精准的参考依据.
Objective To explore the standardized performance of a FISH probe before clinical detection.Methods The probe sensitivity and specificity of ETV6/RUNX1 were analyzed via interphase and metaphase FISH in 20 discarded healthy bone marrow samples.The threshold system of the probe was established using an inverse beta distribution,and an interpretation standard was established.Finally,a parallel-controlled polymerase chain reaction detection study was conducted on 286 bone marrow samples from patients at our hospital.The clinical sensitivity,specificity,and diagnostic coincidence rate of ETV6/RUNX1 FISH detection were analyzed,and the diagnostic consistency of the two methods was analyzed by the kappa test.Results The probe sensitivity and specificity of the ETV6/RUNX1 probe were 98.47%and 100%,respectively.When 50,100,and 200 cells were counted,the typical positive signal pattern cutoffs were 5.81%,2.95%,and 1.49%,respectively,and the atypical positive signal pattern cutoffs were 13.98%,9.75%,and 6.26%,respectively.The clinical sensitivity of FISH was 96.1%,clinical specificity was 99.6%,diagnostic coincidence rate was 99.00%,diagnostic consistency test kappa value was 0.964,and P value was<0.001.Conclusion For FISH probes without a national medical device registration certificate,standardized performance verification and methodology performance verification can be performed using laboratory developed test verification standards to ensure a reliable and accurate reference basis for clinical diagnosis and treatment.

fluorescence in situ hybridizationSensitivitySpecificityThe diagnostic coinci-dence rateLaboratory developed test

肖静、郑迎春、赵佳炜、崔成华、王慧君、孙琦、马娇、马跃申、宋振、肖志坚、李承文

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中国医学科学院血液病医院(中国医学科学院血液学研究所),血液与健康全国重点实验室,国家血液系统疾病临床医学研究中心,细胞生态海河实验室,天津 300020

天津医学健康研究院,天津 301600

荧光原位杂交 灵敏度 特异性 诊断符合率 实验室自建方法

中国医科院医学与健康科技创新工程重大协同创新项目

2022-I2M-1-022

2024

中华血液学杂志
中华医学会

中华血液学杂志

CSTPCD北大核心
影响因子:1.17
ISSN:0253-2727
年,卷(期):2024.45(1)
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