Tebo Anne E, Jaskowski Troy D, Phansalkar Amit R, Litwin Christine M, Branch D Ware, Hill Harry R
Associated Regional and University Pathologists, Institute for Clinical and Experimental Pathology, University of Utah School of Medicine, Salt Lake City, USA.
Am J Clin Pathol. 2008 Jun;129(6):870-5. doi: 10.1309/6MPULFBL24FM9B50.
The diagnostic performance of commercially available nonstandard antiphospholipid (aPL) assays for the evaluation of antiphospholipid syndrome (APS) is unknown. In 62 patients with APS, 88 with recurrent pregnancy loss, 50 healthy blood donors, and 24 women with one or more successful pregnancies, we measured antiphosphatidic acid (aPA), antiphosphatidyl-choline (aPC), antiphosphatidylethanolamine (aPE), antiphosphatidylglycerol (aPG), antiphosphatidylinositol (aPI), and antiphosphatidyl-serine (aPS) IgG and IgM antibodies from 2 manufacturers. We computed the areas under the curve (AUC), sensitivities, specificities, positive and negative predictive values, and 95% confidence intervals to assess diagnostic performance. The AUC analyses of the IgM assays demonstrated significant differences (P < .01) for all markers except aPC, whereas the IgG markers showed comparable performance for most assays with the exception of aPE (P < .01) and aPS (P = .02) antibodies. Overall, the combined sensitivity of the aPL assays differed significantly between manufacturers and did not improve the diagnostic yield for APS.
市售非标准抗磷脂（aPL）检测方法用于评估抗磷脂综合征（APS）的诊断性能尚不清楚。在62例APS患者、88例复发性流产患者、50例健康献血者以及24例有一次或多次成功妊娠的女性中，我们检测了来自2家制造商的抗磷脂酸（aPA）、抗磷脂酰胆碱（aPC）、抗磷脂酰乙醇胺（aPE）、抗磷脂酰甘油（aPG）、抗磷脂酰肌醇（aPI）和抗磷脂酰丝氨酸（aPS）的IgG和IgM抗体。我们计算曲线下面积（AUC）、敏感性、特异性、阳性和阴性预测值以及95%置信区间以评估诊断性能。IgM检测的AUC分析显示，除aPC外，所有标志物均存在显著差异（P <.01），而IgG标志物在大多数检测中表现相当，但aPE（P <.01）和aPS（P =.02）抗体除外。总体而言，aPL检测的联合敏感性在不同制造商之间存在显著差异，且并未提高APS的诊断率。
