Land J A, Gijsen A P, Kessels A G H, Slobbe M E P, Bruggeman C A
Department of Obstetrics and Gynaecology, Academisch Ziekenhuis Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Hum Reprod. 2003 Dec;18(12):2621-7. doi: 10.1093/humrep/deg479.
Micro-immunofluorescence (MIF) is widely used for chlamydia antibody testing (CAT). Recently a species-specific MIF and three enzyme-linked immunosorbent assay (ELISA) tests have been introduced. We compared five commercially available CAT tests, using laparoscopy as a reference, and evaluated whether combinations of tests could improve the predictive value of CAT.
In a consecutive cohort of 315 subfertile women, results of the five CAT tests were correlated to findings at laparoscopy. Likelihood and odds ratios (OR) were calculated for single tests and for combinations of tests.
Of the tests evaluated, MIF Labsystems had the best diagnostic performance (OR 15.7), while pELISA Medac (OR 8.2) was the best of the three ELISA tests. Stepwise logistic regression analysis showed that performance of MIF Labsystems could not be improved by adding a second test. Significant cross-reactivity with C. pneumoniae antibodies was found in all tests evaluated, except in pELISA Medac.
In screening for tubal factor subfertility, MIF Labsystems was superior to the ELISA tests evaluated, and combining two CAT tests did not improve its predictive value. Economic analysis will show whether serial testing by pELISA Medac, and retesting positive samples by MIF Labsystems, is most cost-effective. In CAT, cross-reactivity with C. pneumoniae antibodies is still a major concern.
微量免疫荧光法（MIF）广泛用于衣原体抗体检测（CAT）。最近推出了一种种属特异性MIF和三种酶联免疫吸附测定（ELISA）检测方法。我们以腹腔镜检查作为参考，比较了五种市售的CAT检测方法，并评估检测方法的组合是否能提高CAT的预测价值。
在连续的315名不孕妇女队列中，将五种CAT检测结果与腹腔镜检查结果相关联。计算单项检测及检测组合的似然比和比值比（OR）。
在所评估的检测方法中，MIF Labsystems具有最佳的诊断性能（OR为15.7），而pELISA Medac（OR为8.2）是三种ELISA检测方法中表现最佳的。逐步逻辑回归分析表明，添加第二项检测并不能提高MIF Labsystems的性能。在所评估的所有检测方法中，除pELISA Medac外，均发现与肺炎衣原体抗体有显著交叉反应。
在筛查输卵管因素不孕时，MIF Labsystems优于所评估的ELISA检测方法，且两种CAT检测方法联合使用并不能提高其预测价值。经济分析将表明，pELISA Medac进行系列检测以及MIF Labsystems对阳性样本进行复测是否最具成本效益。在CAT中，与肺炎衣原体抗体的交叉反应仍是一个主要问题。
