摘要
目的观察以磷脂抗原中和或动物血清封闭处理灰区标本后,能否降低以化学发光法(CLIA)检测的梅毒特异性抗体(TPsAb)的假阳性。方法选择以Architect i2000SR检测的TPsAb结果为S/CO>1的标本172例和S/CO<1标本44例,以梅毒螺旋体明胶颗粒凝集试验(TPPA)法进行确认检验。以TPPA为标准,绘制TPsAb的受试者工作特征(ROC)曲线,确定最佳诊断界值及灰区范围。灰区标本以磷脂抗原和小鼠血清分别处理标本后复检,以TPPA为标准,采用Kappa检验比较处理前后的一致性。结果i2000SR的TPsAb最佳诊断界值为3.18,其灵敏度为91.00%,特异度为97.60%;i2000SR的TPsAb灰区范围为0.82~3.98。灰区标本在处理前、磷脂抗原中和后和小鼠血清封闭后,TPsAb与TPPA检测结果的一致性的Kappa值分别为0.56、0.73和0.85。i2000SR检测TPsAb的灵敏度均为99.20%;特异度分别为51.80%、69.90%和83.10%;阳性预测值分别为76.90%、84.20%和90.50%;阴性预测值分别为97.70%、98.30%和98.60%;曲线下面积(AUC)分别为98.20%、98.60%和99.10%。结论灰区标本经磷脂抗原中和或动物血清封闭处理后,可降低CLIA法检测的TPsAb假阳性,其中以动物血清封闭效果更好。
Objective To observe whether the false-positive results of specific antibody of Treponema pallidum(TPsAb) detected by CLIA can be reduced after the gray area samples were neutralized with phospholipid antigen or blocked with animal serum.Methods One hundred and seventy-two samples with S/CO >1 and forty-four samples with S/CO<1 detected by Architect i2000 SR were selected and confirmed by TPPA.Using TPPA as the standard,the ROC curve of TPsAb was drawn to determine the best diagnosis threshold and gray area.The grey area samples were treated with phospholipid antigen and mouse serum respectively,and then re-examined.The consistency was compared by Kappa test with TPPA as the standard.Results The best diagnostic threshold of TPsAb for i2000 SR was 3.18,which its sensitivity was 91.00%,and its specificity was 97.60%.The grey area of TPsAb for i2000 SR was 0.82~3.98.Before treatment,after neutralization of phospholipid antigen and after blocking of mouse serum,the Kappa value of consistency of TPsAb and TPPA was 0.56,0.73 and 0.85 respectively.The sensitivity of i2000 SR to detect TPsAb all were 99.20%,and the specificity was 51.80%,69.90% and 83.10% respectively.The positive predictive values was 76.90%,84.20% and 90.50% respectively,the negative predictive values was 97.70%,98.30% and 98.60% respectively.The AUC was 98.20%,98.60% and 99.10% respectively.Conclusion After neutralized with phospholipid antigen or blocked with animal serum,the false-positive results of TPsAb detected by CLIA can be reduced,the method of blocking with animal serum is better.
作者
曾健
商秀娟
顾芸芸
侯思南
王竹青
顾进
ZENG Jian;SHANG Xiujuan;GU Yunyun;HOU Sinan;WANG Zhuqing;GU Jin(Clinical Laboratory,Nanjing University of Traditional Chinese Medicine Affiliated Lianyungang Hos-pital,Lianyungang 222004,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2020年第9期1091-1094,共4页
The Chinese Journal of Dermatovenereology
作者简介
通信作者:顾进,E-mail:lyggujin1971@163.com。
