Elbers Armin R W, Vos Jan H, Bouma Annemarie, van Exsel Ad C A, Stegeman Arjan
Department of Epidemiology, Animal Health Service, P.O. Box 9, 7400 AA, Deventer, The Netherlands.
Vet Microbiol. 2003 Nov 7;96(4):345-56. doi: 10.1016/j.vetmic.2003.09.005.
The performance of pathological findings as a diagnostic tool for the detection of classical swine fever (CSF) outbreaks during the 1997/1998 CSF-epidemic in The Netherlands was evaluated by constructing and analysing receiver operating characteristic (ROC) curves. This was done at the individual pig level and at the submission level (a group of pigs from the same herd submitted together for post-mortem investigation). At post-mortem examination, the tonsils, spleen, ileo-caecal valve and renal pelvis were sampled, sent to the reference laboratory, and tested by means of a CSF-specific fluorescent antibody test in combination with a confirmatory test. This resulted in an infection status at the individual pig level. The infection status and pathological findings of 1072 individual pigs from a total of 230 infected herds were included in this analysis. We also included submissions of pigs from herds that were sent to post-mortem examination because of a clinically CSF-suspect situation but afterwards were concluded to be from non-infected herds. Infection status and pathological findings of 1224 individual pigs from a total of 241 non-infected herds were included in the analysis. Pneumonia, pleuritis, chronic bronchitis, pulmonary oedema, chronic gastric ulceration, dry faecal contents in the colon, conjunctivitis, haemorrhages in the renal pelvis, renal haemorrhages, splenic enlargement, haemorrhages in the urinary bladder, haemorrhagic and enlarged lymph nodes were the most frequently recorded pathological findings during a post-mortem examination of pigs submitted in a CSF-suspect clinical situation. However, some of these pathological findings (e.g. pneumonia, pleuritis) were almost evenly distributed in infected and in non-infected pigs, resulting in a high sensitivity combined with a low specificity. The area under the ROC curve of pathological findings at the individual pig level and at the submission level was 0.720 and 0.782, respectively, which was significantly (P<0.0001) larger than the area under the random ROC curve. It was concluded that, although gross pathology is a legitimate test, its quantitative contribution to the detection of CSF is limited.
通过构建和分析接受者操作特征（ROC）曲线，对1997/1998年荷兰古典猪瘟（CSF）疫情期间病理检查结果作为检测CSF疫情诊断工具的性能进行了评估。这一评估分别在个体猪水平和送检水平（来自同一猪群一起送检进行尸检的一组猪）上进行。在尸检时，采集扁桃体、脾脏、回盲瓣和肾盂样本，送至参考实验室，并通过CSF特异性荧光抗体检测结合确证试验进行检测。这得出了个体猪水平的感染状况。来自总共230个感染猪群的1072头个体猪的感染状况和病理检查结果被纳入该分析。我们还纳入了因临床怀疑CSF而送去尸检但后来结论为来自未感染猪群的猪群的送检样本。来自总共241个未感染猪群的1224头个体猪的感染状况和病理检查结果被纳入分析。肺炎、胸膜炎、慢性支气管炎、肺水肿、慢性胃溃疡、结肠内干燥粪便、结膜炎、肾盂出血、肾出血、脾脏肿大、膀胱出血、出血性和肿大的淋巴结是在临床怀疑CSF情况下送检猪的尸检过程中最常记录的病理检查结果。然而，其中一些病理检查结果（如肺炎、胸膜炎）在感染猪和未感染猪中几乎均匀分布，导致高敏感性与低特异性相结合。个体猪水平和送检水平的病理检查结果的ROC曲线下面积分别为0.720和0.782，显著（P<0.0001）大于随机ROC曲线下面积。得出的结论是，尽管大体病理学是一种合理的检测方法，但其对CSF检测的定量贡献有限。
