Hughes G B, Barna B P, Kinney S E, Calabrese L H, Nalepa N L
Laryngoscope. 1986 May;96(5):502-5. doi: 10.1288/00005537-198605000-00006.
The purpose of this prospective, controlled study was to estimate the prevalence of immune-mediated (autoimmune) inner ear disease in a high-risk patient population, in order to determine the predictive value of a positive lymphocyte transformation test. The high-risk group was defined as any dizzy patient with unilateral or bilateral-asymmetric sensorineural hearing loss, who had not previously received immunotherapy. From more than 400 consecutive patients with a chief complaint of dizziness, 58 were entered into the study over an 8-month period. The control group consisted of 15 normal volunteers. Thirteen patients (22%) one control (7%) had positive lymphocyte transformation tests. The data suggest that positive results in "high-risk" patients are more common than previously believed. Assuming test sensitivity is 96%, specificity 93%, and disease prevalence 22% in high-risk patients, the predictive value of a positive lymphocyte transformation test using inner ear membranes is 79%. That is, approximately three fourths of all positive results are true positives. Positive results in suspected patients, therefore, should be considered true positives, and treatment recommended. Future research should attempt to refine the putative antigen(s), further define "high risk" patients, and prospectively verify these preliminary results.
这项前瞻性对照研究的目的是评估免疫介导（自身免疫性）内耳疾病在高危患者群体中的患病率，以确定淋巴细胞转化试验阳性的预测价值。高危组定义为既往未接受过免疫治疗的单侧或双侧不对称感音神经性听力损失的眩晕患者。在400多名以眩晕为主诉的连续患者中，8个月内有58名患者进入研究。对照组由15名正常志愿者组成。13例患者（22%）和1例对照（7%）淋巴细胞转化试验呈阳性。数据表明，“高危”患者的阳性结果比之前认为的更为常见。假设检测敏感性为96%，特异性为93%，高危患者疾病患病率为22%，使用内耳膜进行淋巴细胞转化试验阳性的预测价值为79%。也就是说，所有阳性结果中约四分之三为真阳性。因此，疑似患者的阳性结果应被视为真阳性，并建议进行治疗。未来的研究应尝试完善假定抗原，进一步明确“高危”患者，并前瞻性验证这些初步结果。
