Analysis on the clinical value of methods used for the detection of treponema pallidum antibody / 中华流行病学杂志

ABSTRACT

Objective To explore the clinical value of five methods commonly used for the detection of clinical syphilis antibody.Methods A total of 160 confirmed syphilis cases were chosen as the experimental group while 200 non-syphilis cases were set as the control group.Serum specimens were detected by methods as Treponema pallidum particle agglutination assay (TPPA),chemiluminescent microparticle immune assay (CMIA),enzyme linked immunosorbent assay (ELISA),emulsion method (TP-AD) and toluidine red unheated serum test (TRUST).Sensitivity and specificity were evaluated on five methods.Titers of syphilis antibody in different stages and pre/post on treament among syphilis patients were compared and analyzed under the five methods.Results The sensitivity vs.specificity of TPPA,CMIA,ELISA,TP-AD and TRUST appeared as 100.00％ vs.99.50％,99.38％ vs.99.00％,98.12％ vs.99.00％,94.38％ vs.94.50％ and 85.62％ vs.95.50％,respectively.Among the patients at primary or latent stages,the syphilis antibody positive rate detected by TRUST appeared lower than that detected by ELISA,TPPA,CMIA or TP-AD,and the differences were statistically significant (P＜0.01).There were no statistical differences in the syphilis antibody positive rate of syphilis patients in the secondary or tertiary stages detected by five methods (P＞0.05).In each stage of the syphilis patients,the syphilis antibody positive rate detected by ELISA or of CMIA combined with TRUST both reached 100.00％.Before and after treatment in 121 cases of confirmed syphilis,there was statistically significant difference in the syphilis antibody positive rate detected by TRUST method (P＜0.05).There was no statistical significance in the syphilis antibody positive rate detected by other four methods (P＞0.05).Conclusions The sensitivity and specificity of TPPA,CMIA and ELISA methods were better.Methods as ELISA or as CMIA combined with TRUST both appeared reliable for syphilis screening in every stage of the disease.TRUST was suitable for the determination of active stage syphilis and monitoring the effects after treatment.