From the Laboratory of Molecular Biology and Genetics (LABIOGENE), Joseph KI-ZERBO University.
National Center for Blood Transfusion in Burkina Faso (CNTS), Ouagadougou, Burkina Faso.
Sex Transm Dis. 2022 Jul 1;49(7):469-476. doi: 10.1097/OLQ.0000000000001633. Epub 2022 Mar 25.
Syphilis continues to be a public health problem, and its diagnosis still has limitations. Molecular diagnosis provides an alternative for rapid and effective management. The objective is to determine the accuracy of tests in the molecular diagnosis of syphilis.
We searched PubMed and Web of Sciences for articles related to molecular detection of syphilis from January 1, 2009, to December 31, 2019. The bivariate Reitsma model and the hierarchical receiver operating characteristic curve model were used to evaluate the diagnostic performance of molecular tests at a 95% confidence interval. A subgroup meta-analysis was performed to explore sources of heterogeneity.
Forty-seven articles were identified for qualitative synthesis, of which 23 met the inclusion criteria for meta-analysis. The pooled sensitivities in conventional polymerase chain reaction (PCR) and real-time PCR were 77.52 (59.50-89.01) and 68.43 (54.96-79.39), respectively. The pooled specificities were 98.00 (90.73-99.59) and 98.84 (97.55-99.46), respectively. Ulcer samples had a better performance (sensitivity of 79.88 [69.00-87.62] and specificity of 98.58 [97.25-99.27]), and the major target genes were the polymerase A gene and tpp47 gene.
Our work showed that conventional PCR was more widely used than real-time PCR in the diagnosis of syphilis, and ulcers were the best specimens. Sample types and target genes are factors that may influence the quality of the different tests. These results could provide evidence for further work in the direction of providing a more efficient diagnostic test.
梅毒仍然是一个公共卫生问题，其诊断仍然存在局限性。分子诊断为快速有效的管理提供了一种替代方法。目的是确定梅毒分子诊断中各种检测方法的准确性。
我们检索了 PubMed 和 Web of Sciences 数据库中 2009 年 1 月 1 日至 2019 年 12 月 31 日期间与梅毒分子检测相关的文章。采用双变量 Reitsma 模型和分层受试者工作特征曲线模型在 95%置信区间评估分子检测的诊断性能。进行亚组荟萃分析以探索异质性的来源。
定性综合分析确定了 47 篇文章，其中 23 篇符合荟萃分析的纳入标准。传统聚合酶链反应（PCR）和实时 PCR 的汇总敏感性分别为 77.52（59.50-89.01）和 68.43（54.96-79.39）。汇总特异性分别为 98.00（90.73-99.59）和 98.84（97.55-99.46）。溃疡样本的性能更好（敏感性为 79.88 [69.00-87.62]，特异性为 98.58 [97.25-99.27]），主要目标基因是聚合酶 A 基因和 tpp47 基因。
我们的工作表明，在梅毒诊断中，传统 PCR 的应用比实时 PCR 更为广泛，而溃疡是最佳样本。样本类型和目标基因是可能影响不同检测方法质量的因素。这些结果可为进一步开发更有效的诊断检测方法提供证据。
