Clin Lab. 2024 Nov 1;70(11). doi: 10.7754/Clin.Lab.2024.240430.
In areas where C. sinensis is endemic, early screening and diagnosis of C. sinensis infection is crucial to prevent complications and interrupt the chain of transmission. Testing for C. sinensis IgG antibodies is frequently employed as a screening method for detecting the disease. However, its effectiveness in populations with a high risk remains to be determined. This study aimed to evaluate the clinical value of IgG antibody testing for screening C. sinensis infection in high-risk populations.
Between October 2020 and September 2023, 1,080 participants from Liuzhou Municipal Liutie Central Hospital patients were recruited. All participants underwent enzyme-linked immunosorbent assay (ELISA) to detect IgG antibodies and fecal examination for C. sinensis eggs using the Kato-Katz technique. The study examined the diagnostic concordance between two methods by using inter-rater agreement evaluation (Kappa). The diagnostic effectiveness of IgG antibodies was assessed comprehensively and across different gender and age categories, with the outcomes of the parasite egg test serving as the benchmark for diagnosis.
Out of the 1,080 participants, 48.0% (518/1,080) tested positive for C. sinensis eggs, and 46.9% (506/1,080) tested positive for IgG antibodies. The Kappa value of the two methods' diagnostic concordance was 0.599. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IgG antibody detection were 78.0%, 81.9%, 79.8%, 80.1%, and 80.0%, respectively, using C. sinensis eggs as the diagnostic criterion. Gender and age subgroup analyses revealed that diagnostic specificity, negative predictive value (NPV), and accuracy were higher in females than males (p = 0.003, 0.001, and 0.049, respectively). Sensitivity tended to decrease, while specificity tended to increase with age (p = 0.007 and 0.010, respectively).
The technique for detecting Clonorchiasis IgG antibodies has a certain degree of accuracy in diagnosing C. sinensis, but its sensitivity is low, particularly in mild infections and in the elderly population. Diagnosis requires a combination of other assays or further optimization of the technique's performance.
在华支睾吸虫流行地区，早期筛查和诊断华支睾吸虫感染对于预防并发症和阻断传播链至关重要。检测华支睾吸虫 IgG 抗体常被用作筛查该病的方法。然而，其在高危人群中的有效性仍有待确定。本研究旨在评估 IgG 抗体检测在高危人群中筛查华支睾吸虫感染的临床价值。
2020 年 10 月至 2023 年 9 月，我们招募了柳州市柳铁中心医院的 1080 名患者。所有参与者均接受酶联免疫吸附试验（ELISA）检测 IgG 抗体，并采用加藤厚涂片法检测粪便中的华支睾吸虫卵。本研究通过采用组内一致性评价（Kappa）评估两种方法的诊断一致性。综合评估不同性别和年龄组的 IgG 抗体诊断效果，以寄生虫卵检测结果作为诊断基准。
在 1080 名参与者中，518 名（48.0%）检测出华支睾吸虫卵阳性，506 名（46.9%）检测出 IgG 抗体阳性。两种方法诊断一致性的 Kappa 值为 0.599。以华支睾吸虫卵检测结果为诊断基准，IgG 抗体检测的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为 78.0%、81.9%、79.8%、80.1%和 80.0%。性别和年龄亚组分析显示，女性的诊断特异度、阴性预测值（NPV）和准确率均高于男性（p=0.003、0.001 和 0.049）。随着年龄的增长，敏感性有下降趋势，而特异性有上升趋势（p=0.007 和 0.010）。
检测华支睾吸虫 IgG 抗体的技术在诊断华支睾吸虫方面具有一定的准确性，但灵敏度较低，特别是在轻度感染和老年人群中。诊断需要结合其他检测方法或进一步优化该技术的性能。
