Dąbrowska Julia, Groblewska Maria, Bendykowska Maria, Sikorski Maksymilian, Gromadzka Grażyna
Chair and Department of General Biology and Parasitology, Medical University of Warsaw, ul. Chalubinskiego 5, 02-004 Warsaw, Poland.
Student Scientific Association, Department of General Biology and Parasitology, Medical University of Warsaw, ul. Chalubinskiego 5, 02-004 Warsaw, Poland.
Diagnostics (Basel). 2024 Sep 27;14(19):2148. doi: 10.3390/diagnostics14192148.
(1) Introduction: Gastrointestinal parasites (GIPs) are one of the most common causes of disease in the world. Clinical diagnosis of most parasitic diseases is difficult because they do not produce characteristic symptoms. (2) Methods: The PubMed, Science Direct, and Wiley Online Library medical databases were reviewed using the following phrases: "parasitic infections and diagnostics", "intestinal parasites", "gastrointestinal parasites", "parasitic infections and diagnostics", and their combinations. (3) Results and Conclusions: Correct diagnosis of GIP involves determining the presence of a parasite and establishing a relationship between parasite invasion and disease symptoms. The diagnostic process should consider the possibility of the coexistence of infection with several parasites at the same time. In such a situation, diagnostics should be planned with consideration of their frequency in each population and the local epidemiological situation. The importance of the proper interpretation of laboratory test results, based on good knowledge of the biology of the parasite, should be emphasized. The presence of the parasite may not be causally related to the disease symptoms. Due to wide access to laboratories, patients often decide to perform tests themselves without clinical justification. Research is carried out using various methods which are often unreliable. This review briefly covers current laboratory methods for diagnosing the most common gastrointestinal parasitic diseases in Europe. In particular, we provide useful information on the following aspects: (i) what to look for and where to look for it (suitability of feces, blood, duodenal contents, material taken from endoscopy or biopsy, tissue samples, and locations for searching for eggs, cysts, parasites, parasite genetic material, and characteristics of immune responses indicating parasitic infections); (ii) when material should be collected for diagnosis and/or to check the effectiveness of treatment; (iii) how-that is, by what methods-laboratory diagnostics should be carried out. Here, the advantages and disadvantages of direct and indirect methods of detecting parasites will be discussed. False-positive or false-negative results are a problem facing many tests. Available tests have different sensitivities and specificities. Therefore, especially in doubtful situations, tests for the presence of the pathogen should be performed using various available methods. It is important that the methods used make it possible to distinguish an active infection from a past infection. Finally, we present laboratory "case reports", in which we will discuss the diagnostic procedure that allows for the successful identification of parasites. Additionally, we briefly present the possibilities of using artificial intelligence to improve the effectiveness of diagnosing parasitic diseases.
(1) 引言:胃肠道寄生虫(GIPs)是全球最常见的致病原因之一。大多数寄生虫病的临床诊断都很困难,因为它们不会产生特征性症状。(2) 方法:使用以下检索词对PubMed、ScienceDirect和Wiley Online Library医学数据库进行了检索:“寄生虫感染与诊断”、“肠道寄生虫”、“胃肠道寄生虫”、“寄生虫感染与诊断”及其组合。(3) 结果与结论:正确诊断胃肠道寄生虫需要确定寄生虫的存在,并建立寄生虫感染与疾病症状之间的关联。诊断过程应考虑同时感染多种寄生虫的可能性。在这种情况下,应根据每种寄生虫在各人群中的感染频率以及当地的流行病学情况来规划诊断方法。应强调基于对寄生虫生物学的充分了解来正确解读实验室检测结果的重要性。寄生虫的存在可能与疾病症状并无因果关系。由于实验室检测容易获取,患者常常在没有临床依据的情况下自行决定进行检测。研究采用的各种方法往往并不可靠。本综述简要介绍了欧洲目前诊断最常见胃肠道寄生虫病的实验室方法。特别是,我们在以下方面提供了有用信息:(i) 寻找什么以及在哪里寻找(粪便、血液、十二指肠内容物、内镜检查或活检获取的材料、组织样本的适用性,以及寻找虫卵、囊肿、寄生虫、寄生虫遗传物质的部位,以及表明寄生虫感染的免疫反应特征);(ii) 何时应采集材料进行诊断和/或检查治疗效果;(iii) 如何进行——即通过何种方法——进行实验室诊断。在此,将讨论检测寄生虫的直接和间接方法的优缺点。假阳性或假阴性结果是许多检测面临的问题。现有检测方法具有不同的敏感性和特异性。因此,尤其是在存在疑问的情况下,应使用各种可用方法进行病原体检测。重要的是,所采用的方法应能够区分现症感染和既往感染。最后,我们展示实验室“病例报告”,其中将讨论能够成功鉴定寄生虫的诊断程序。此外,我们简要介绍了使用人工智能提高寄生虫病诊断效率的可能性。