CXCL13 及脑脊液血清学检测在神经梅毒患者中的诊断作用。

Diagnostic role of CXCL13 and CSF serology in patients with neurosyphilis.

机构信息

Division of Clinical microbiology, Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China.

Division of Clinical microbiology, Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China

出版信息

Sex Transm Infect. 2021 Nov;97(7):485-489. doi: 10.1136/sextrans-2020-054778. Epub 2021 Jan 12.

DOI:10.1136/sextrans-2020-054778

PMID:33436504

Abstract

BACKGROUND

Considering the unknown prevalence of neurosyphilis in West China, and the confusing diagnosis of neurosyphilis, the role of CSF_CXCL13 and syphilis serology was studied to provide a more accurate reference for the clinical detection and diagnosis of neurosyphilis.

METHODS

A retrospective data set I was used to investigate the prevalence of neurosyphilis, as well as the laboratory characteristics of 244 patients. Besides, to explore the diagnostic value of CSF_CXCL13 and syphilis serology for neurosyphilis, another 116 CSF_serum paired samples (data set II) were collected from 44 neurosyphilis and 72 non-neurosyphilis/syphilis patients.

RESULTS

About 6.25% (156 out of 2494) syphilis was neurosyphilis. When infection occurs, syphilis serology (sero_TRUST ≥1:16 and sero_TPPA titre ≥1:10240) can be good predictors of neurosyphilis, as well as syphilis CSF serology (CSF_TPPA ≥1:320, CSF_TRUST and venereal disease research laboratory). The sensitivity of serology in neurosyphilis can be complemented by CSF_CXCL13, which could be the therapy monitor of neurosyphilis.

CONCLUSION

Due to the lack of ideal biomarkers for neurosyphilis, the importance of syphilis serology cannot be ignored, and their combination with CSF_CXCL13 or other biomarkers should be further investigated.

摘要

背景

鉴于华西地区神经梅毒的未知患病率，以及神经梅毒诊断的混乱，本研究旨在探讨 CSF_CXCL13 和梅毒血清学在神经梅毒中的作用，为神经梅毒的临床检测和诊断提供更准确的参考。

方法

回顾性数据集中 I 用于调查神经梅毒的患病率，以及 244 例患者的实验室特征。此外，为了探讨 CSF_CXCL13 和梅毒血清学对神经梅毒的诊断价值，我们还从 44 例神经梅毒和 72 例非神经梅毒/梅毒患者中收集了 116 对 CSF_血清样本（数据集 II）。

结果

约 6.25%（2494 例中的 156 例）的梅毒为神经梅毒。当感染发生时，梅毒血清学（血清 TRUST≥1:16 和血清 TPPA 滴度≥1:10240）可以很好地预测神经梅毒，以及梅毒 CSF 血清学（CSF_TPPA≥1:320、CSF_TRUST 和性病研究实验室）。CSF_CXCL13 可以补充血清学在神经梅毒中的敏感性，可作为神经梅毒的治疗监测指标。