Lissandrin Raffaella, Tamarozzi Francesca, Piccoli Luca, Tinelli Carmine, De Silvestri Annalisa, Mariconti Mara, Meroni Valeria, Genco Francesca, Brunetti Enrico
Department of Infectious Diseases, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Clinical Epidemiology and Biometry Unit, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; Department of Microbiology and Virology, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Clinical Therapy, University of Pavia, Italy.
Department of Infectious Diseases, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Clinical Epidemiology and Biometry Unit, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; Department of Microbiology and Virology, Istituto Di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Clinical Therapy, University of Pavia, Italy
Am J Trop Med Hyg. 2016 Jan;94(1):166-71. doi: 10.4269/ajtmh.15-0219. Epub 2015 Oct 26.
Knowledge of variables influencing serology is crucial to evaluate serology results for the diagnosis and clinical management of cystic echinococcosis (CE). We analyzed retrospectively a cohort of patients with hepatic CE followed in our clinic in 2000-2012 to evaluate the influence of several variables on the results of commercial enzyme-linked immunosorbent assay (ELISA) and indirect hemagglutination (IHA) tests. Sera from 171 patients with ≥ 1 hepatic CE cyst, and 90 patients with nonparasitic cysts were analyzed. CE cysts were staged according to the WHO-IWGE classification and grouped by activity. A significant difference in ELISA optical density (OD) values and percentage of positivity was found among CE activity groups and with controls (P < 0.001). The serological response was also influenced by age (P < 0.001) and cyst number (P = 0.003). OD values and cyst size were positively correlated in active cysts (P = 0.001). IHA test showed comparable results. When we analyzed the results of 151 patients followed over time, we found that serology results were significantly influenced by cyst activity, size, number, and treatment ≤ 12 months before serum collection. In conclusion, serological responses as assessed by commercial tests depend on CE cyst activity, size and number, and time from treatment. Clinical studies and clinicians in their practice should take this into account.
了解影响血清学的变量对于评估血清学检测结果以诊断和临床管理囊性棘球蚴病（CE）至关重要。我们回顾性分析了2000年至2012年在我们诊所随访的一组肝CE患者，以评估几个变量对商业酶联免疫吸附测定（ELISA）和间接血凝试验（IHA）结果的影响。分析了171例患有≥1个肝CE囊肿的患者以及90例非寄生虫囊肿患者的血清。CE囊肿根据世界卫生组织-国际包虫病协会（WHO-IWGE）分类进行分期，并按活性分组。在CE活性组与对照组之间，ELISA光密度（OD）值和阳性百分比存在显著差异（P < 0.001）。血清学反应还受年龄（P < 0.001）和囊肿数量（P = 0.003）的影响。活性囊肿的OD值与囊肿大小呈正相关（P = 0.001）。IHA试验显示了类似的结果。当我们分析151例随时间随访患者的结果时，我们发现血清学结果受囊肿活性、大小、数量以及血清采集前≤12个月的治疗情况的显著影响。总之，商业检测评估的血清学反应取决于CE囊肿的活性、大小、数量以及治疗后的时间。临床研究和临床医生在实践中应考虑到这一点。
