Laboratório de Vigilância em Leishmanioses, Instituto de Pesquisa Clínica Evandro Chagas, Rio de Janeiro, RJ, Brasil.
Mem Inst Oswaldo Cruz. 2010 Feb;105(1):109-12. doi: 10.1590/s0074-02762010000100018.
The present study investigated the diagnostic value of polymerase chain reaction (PCR) performed in parallel to conventional methods at an American tegumentary leishmaniasis (ATL) referral centre for diagnosis. Accuracy parameters for PCR were calculated using 130 patients with confirmed ATL (ATL group), 15 patients established with other diseases and 23 patients with a lesion suggestive of ATL, but without parasitological confirmation (NDEF group). PCR showed 92.3% sensitivity, 93.3% specificity, a 99.2% positive predictive value and a 13.84 positive likelihood ratio. In the NDEF group, PCR confirmed ATL in 13 of the 23 patients, seven of whom responded to leishmaniasis treatment and six who presented spontaneous healing of the lesion. PCR should be included in the routine diagnostic procedures for ATL, especially for cases found to be negative by conventional methods.
本研究旨在探讨聚合酶链反应(PCR)在一家美国皮肤利什曼病(ATL)转诊中心与传统方法并行进行诊断时的诊断价值。使用 130 例确诊 ATL(ATL 组)、15 例确诊其他疾病患者和 23 例疑似 ATL 但无寄生虫学确认的皮损患者(NDEF 组)计算 PCR 的准确性参数。PCR 的灵敏度为 92.3%,特异性为 93.3%,阳性预测值为 99.2%,阳性似然比为 13.84。在 NDEF 组中,PCR 证实 23 例患者中的 13 例患有 ATL,其中 7 例对利什曼病治疗有反应,6 例皮损自行愈合。PCR 应纳入 ATL 的常规诊断程序,尤其是对传统方法检测为阴性的病例。