Eris Fatma Nur, Akisu Ciler, Aksoy Umit
Department of Microbiology, Institue of National Health, Izmir, Turkey.
Korean J Parasitol. 2009 Dec;47(4):427-9. doi: 10.3347/kjp.2009.47.4.427. Epub 2009 Dec 1.
To establish a definite diagnosis for pulmonary hydatid disease, combination of radiology and serology is useful. In this study, 19 preoperative sera from patients with surgically confirmed pulmonary hydatidosis, 40 sera from patients with other parasitosis and pulmonary diseases, and 20 sera from healthy donors were evaluated using 4 different serological tests, i.e., the commercial ELISA (ELISA-kit) test, the ELISA (ELISA-lab) test prepared in our laboratory, the commercial indirect hemagglutination assay kit (IHA-kit) test, and the IHA test using sensitized sheep red blood cells with tannic acid (IHA-TA). The ELISA-kit was the most sensitive (84.2%) and the most specific test (100.0%). The ELISA-kit also demonstrated the highest positive (100.0%) and negative (95.2%) predictive values. The sensitivity of the ELISA-lab test, that we prepared, was found to be 73.6%, whereas the IHA-kit test and the IHA-TA test were found to be 73.6% and 68.4%, respectively. The specificity of these tests was 96.6%, 98.3%, and 83.3%, respectively. When all 4 tests were assessed together, it was found that the sensitivity had risen to 94.7%. When the ELISA-kit was assessed with the IHA-kit and IHA-TA together, it was found that the sensitivity was 89.5% and 84.2%, respectively. Likewise, the combination of the ELISA-lab and IHA-kit or IHA-TA allowed us to achieve a sensitivity of 84.2% in cases of pulmonary echinococcosis. In conclusion, the diagnosis would be imminent if least 2 tests were applied together.
为明确诊断肺包虫病,放射学检查与血清学检查相结合很有用。在本研究中,使用4种不同的血清学检测方法对19例手术确诊为肺包虫病患者的术前血清、40例患有其他寄生虫病和肺部疾病患者的血清以及20例健康供者的血清进行了评估,这4种检测方法分别是商用酶联免疫吸附测定(ELISA试剂盒)检测、我们实验室制备的ELISA(ELISA实验室法)检测、商用间接血凝试验试剂盒(IHA试剂盒)检测以及使用经单宁酸致敏的绵羊红细胞的IHA检测(IHA-TA)。ELISA试剂盒是最敏感的检测方法(84.2%)且特异性最高(100.0%)。ELISA试剂盒还显示出最高的阳性预测值(100.0%)和阴性预测值(95.2%)。我们制备的ELISA实验室法检测的敏感性为73.6%,而IHA试剂盒检测和IHA-TA检测的敏感性分别为73.6%和68.4%。这些检测方法的特异性分别为96.6%、98.3%和83.3%。当对所有4种检测方法一起评估时,发现敏感性提高到了94.7%。当将ELISA试剂盒与IHA试剂盒和IHA-TA一起评估时,发现敏感性分别为89.5%和84.2%。同样,ELISA实验室法与IHA试剂盒或IHA-TA联合使用,使我们在肺棘球蚴病病例中达到了84.2%的敏感性。总之,如果同时应用至少2种检测方法,诊断将很快明确。