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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Diagnostic Performances of Commercial ELISA, Indirect Hemagglutination, and Western Blot in Differentiation of Hepatic Echinococcal and Non-Echinococcal Lesions: A Retrospective Analysis of Data from a Single Referral Centre
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Diagnostic Performances of Commercial ELISA, Indirect Hemagglutination, and Western Blot in Differentiation of Hepatic Echinococcal and Non-Echinococcal Lesions: A Retrospective Analysis of Data from a Single Referral Centre

机译：肝超声波和非呼吸功能亢进病变分化的商业ELISA，间接血凝和蛋白质印迹的诊断性能：从单个推荐中心的数据回顾性分析

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摘要

The diagnosis of cystic echinococcosis (CE) is based on imaging. Serology supports imaging in suspected cases, but no consensus exists on the algorithm to apply when imaging is inconclusive. We performed a retrospective analysis of serology results of patients with untreated hepatic CE and non-CE lesions, seen from 2005 to 2017, to evaluate their accuracy in the differential diagnosis of hepatic CE. Serology results of three seroassays for echinococcosis (ELISA RIDASCREEN, indirect hemagglutination (IHA) Cellognost, and Western blot LDBIO) and clinical characteristics of eligible patients were retrieved. Patients were grouped as having active or inactive CE and liquid or solid non-CE lesions. Sensitivity, specificity, and diagnostic accuracy were compared between scenarios encompassing different test combinations. Eligible patients included 104 patients with CE and 257 with non-CE lesions. Sensitivity and diagnostic accuracy of Western blot (WB) were significantly higher than those of the following: 1) IHA or ELISA alone, 2) IHA+ELISA interpreted as positive if both or either tests positive, and 3) IHA+ELISA confirmed by WB if discordant. The best performances were obtained when WB was applied on discordant or concordant negative IHA+ELISA. Analyses performed within "active CE (n = 52) versus liquid non-CE (n = 245)" and " inactive CE (n = 52) versus solid non-CE (n = 12)" groups showed similar results. Specificity was high for all tests (0.99-1.00) and did not differ between test combination scenarios. WB may be the best test to apply in a one-test approach. Two first-level tests confirmed by WB seem to provide the best diagnostic accuracy. Further studies should be performed in different settings, especially where lower test specificity is likely.
机译：对囊性超声波功能亢进（CE）的诊断基于成像。血清学支持疑似病例的成像，但在成像不确定时，算法不存在达成共识。我们对2005年至2017年的未经处理的肝CE和非CE病变进行了回顾性分析，从2005年到2017年，评价其在肝CE的差异诊断中的准确性。检测到三种血清腺炎（ELISA Ridscreen，间接血凝（IHA）Cellognost和Western Blot Ldbio）和符合条件患者的临床特征的血清腺术结果。将患者分组为具有活性或无活性CE和液体或固体非CE病变。在包括不同测试组合的情况下比较了灵敏度，特异性和诊断准确性。符合条件的患者包括104例CE和257名，非CE病变。蛋白质印迹（WB）的敏感性和诊断准确性明显高于以下：1）IHA或ELISA，2）IHA + ELISA解释为阳性或试验阳性，3）IHA + ELISA通过WB证实如果不安。当Wb应用于不和谐的阴性IHA + ELISA时，获得了最佳性能。在“有源Ce（n = 52）与液体非Ce（n = 245）”和“无效CE（n = 52）与固体非Ce（n = 12）的内分析显示出类似的结果。所有测试的特异性高（0.99-1.00），测试组合方案之间没有区别。 WB可能是以一次性测试方法应用的最佳测试。 WB确认的两个第一级测试似乎提供了最佳的诊断准确性。进一步的研究应在不同的环境中进行，特别是在可能的情况下可能存在较低的测试特异性。

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