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[4种乳胶凝集试剂检测抗梅毒螺旋体抗体浓度的基本性能评价及决策不匹配样本的详细调查]

[Evaluation of the Fundamental Performance of 4 Latex Agglutination Reagents to Measure Anti-TP Antibody Concentration and Detailed Investigation of Decision-Mismatched Samples].

作者信息

Ito Atsushi, Niizeki Noriyasu, Kurose Hitomi, Yonezawa Takatoshi, Sasaki Rie, Tachibana Mineji, Tomoda Yutaka, Kino Shuichi, Fujii Satoshi

出版信息

Rinsho Byori. 2015 Jan;63(1):25-31.

Abstract

Serological diagnosis of syphilis can be made by using the serological test for syphilis (STS) method for detecting a lipid antibody and Treponema pallidum (TP) method for detecting the anti-TP-specific antibody. In STS and TP methods, the basis using latex agglutination reaction has been used in many facilities. However, in latex agglutination, false-positive results due to non-specific reaction have sometimes been obtained in reactions of a routine laboratory test reagent detecting the anti-TP antibody used in our medical laboratory. We evaluated the fundamental performance of 4 reagents to measure anti-TP antibody concentration using latex agglutination: Reagents A, B, C and D produced by SEKISUI MEDICAL, FUJI REBIO, DENKA SEIKEN and SHINO TEST, respectively. We examined the correlations between Reagent A (routine laboratory test reagent) and Reagents B, C, and D in sera from 68 patients, and we performed additional investigation by using a neutralization test, immunochromatography, Western blotting, FTA-ABS (IgG), and STS method by an automatic analyzer for 13 decision-mismatched samples. The fundamental performance of each reagent was as good as that previously reported. Eight of the 13 decision-mismatched samples were false positives due to non-specific reaction of Reagent A. In latex agglutination non-specific reaction is inevitable. However, this study strongly suggests that using a neutralization test and immunochromatography that can be performed quickly is sufficient to verify whether positive reactions are true or false.

摘要

梅毒的血清学诊断可通过梅毒血清学检测(STS)方法检测脂质抗体以及梅毒螺旋体(TP)方法检测抗TP特异性抗体来进行。在STS和TP方法中,许多机构都采用了基于乳胶凝集反应的原理。然而,在乳胶凝集试验中,我们医学实验室中用于检测抗TP抗体的常规实验室检测试剂在反应中有时会因非特异性反应而出现假阳性结果。我们评估了4种使用乳胶凝集法测量抗TP抗体浓度的试剂的基本性能:试剂A、B、C和D分别由积水医疗株式会社、富士瑞必欧株式会社、电気化学工业株式会社和志野テスト株式会社生产。我们检测了68例患者血清中试剂A(常规实验室检测试剂)与试剂B、C和D之间的相关性,并对13例判定结果不一致的样本通过中和试验、免疫层析法、蛋白质印迹法、荧光螺旋体抗体吸收试验(IgG)以及自动分析仪进行的STS方法进行了进一步研究。每种试剂的基本性能与先前报道的一样好。13例判定结果不一致的样本中有8例是由于试剂A的非特异性反应导致的假阳性。在乳胶凝集试验中,非特异性反应是不可避免的。然而,本研究强烈表明,使用能够快速进行的中和试验和免疫层析法足以验证阳性反应是真阳性还是假阳性。

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