Chen X, Chen X, Lu X, Feng X, Wen H
The Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Parasite Immunol. 2015 Jan;37(1):10-5. doi: 10.1111/pim.12151.
Clinical diagnosis and post-surgery assessment of cystic echinococcosis depend on laboratory serodiagnosis and ultrasound examinations. This study aims to produce the recombinant antigen (rAgB) and compare its diagnostic effect with natural antigens (crude fluid antigen, protoscolex antigen). After rAgB, crude fluid antigen, protoscolex antigen were produced, and the diagnostic accuracy was evaluated with dot immunogold filtration assay (DIGFA) by the sera from the following groups: surgically confirmed cystic echinococcosis patients (n = 113), alveolar echinococcosis patients (n = 46), other parasitic diseases (n = 49), nonparasitic hepatic diseases (n = 63) and healthy people (n = 121). In diagnosing cystic echinococcosis, the sensitivity of recombinant AgB was 77.9% and the specificity was 98.3%. The crude fluid antigen B showed a sensitivity of 92.9% and specificity of 81.0%. The protoscolex antigen had sensitivity of 87.6% and specificity of 90.9%. The recombinant AgB indicates the advantage of no cross-reaction with other parasite diseases or nonparasite hepatic diseases. Recombinant antigen B can improve the specificity but decrease the sensitivity. The combination of native and recombinant antigens will improve the overall performance of serodiagnosis of cystic echinococcosis.
囊型包虫病的临床诊断及术后评估依赖于实验室血清学诊断和超声检查。本研究旨在制备重组抗原(rAgB),并将其诊断效果与天然抗原(囊液粗抗原、原头节抗原)进行比较。制备rAgB、囊液粗抗原、原头节抗原后,采用斑点免疫金渗滤法(DIGFA),用以下几组血清评估诊断准确性:手术确诊的囊型包虫病患者(n = 113)、泡型包虫病患者(n = 46)、其他寄生虫病患者(n = 49)、非寄生虫性肝病患者(n = 63)和健康人(n = 121)。在诊断囊型包虫病时,重组AgB的敏感性为77.9%,特异性为98.3%。囊液粗抗原B的敏感性为92.9%,特异性为81.0%。原头节抗原的敏感性为87.6%,特异性为90.9%。重组AgB显示出与其他寄生虫病或非寄生虫性肝病无交叉反应的优势。重组抗原B可提高特异性但降低敏感性。天然抗原与重组抗原联合使用将提高囊型包虫病血清学诊断的整体性能。