Hsiao Ke-Yu, Lin Hsiu-Ling, Chen Hui-Mei, Chen Cheng-Chieh
Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Department of Nursing, Landseed International Hospital, Taoyuan, Taiwan.
J Low Genit Tract Dis. 2025 Jul 1;29(3):273-279. doi: 10.1097/LGT.0000000000000873. Epub 2025 Jan 22.
Trichomoniasis is a globally prevalent sexually transmitted infection caused by the protozoan Trichomonas vaginalis . Polymerase chain reaction (PCR) is the gold standard for diagnosing trichomoniasis, but it is expensive. Antigen tests are immunochromatographic immunoassays that detect T. vaginalis membrane proteins. Despite being user-friendly and rapid, the diagnostic accuracy of antigen tests remains uncertain. Therefore, this meta-analysis aimed to evaluate the diagnostic accuracy of antigen tests for T. vaginalis infections.
The authors mined the PubMed, Embase, and Cochrane Library databases for studies evaluating the diagnostic accuracy of antigen tests for T. vaginalis . They included studies that provided diagnostic test accuracy data in order to conduct a meta-analysis. They evaluated antigen tests based on immunochromatography and lateral flow devices. The meta-analysis was conducted by using the hierarchical summary receiver operating characteristic model.
Eleven studies with 5,884 samples were included. The meta-analysis yielded a pooled sensitivity of 87.0% and a pooled specificity of 98.3%. A subgroup analysis employing PCR as the reference standard yielded a sensitivity of 58.5%, whereas another subgroup analysis using culture returned a sensitivity of 95.9%. The subgroup analysis of 6 studies comprising 2,328 specimens from symptomatic individuals yielded a pooled sensitivity of 85% and a specificity of 99.9%.
The antigen tests exhibited high sensitivity and specificity. Additionally, subgroup analyses revealed that antigen tests demonstrated greater sensitivity in diagnosing symptomatic patients compared to asymptomatic individuals. While less sensitive than PCR, antigen testing remains a promising avenue for detecting T. vaginalis infections.
滴虫病是一种由阴道毛滴虫原虫引起的全球流行的性传播感染。聚合酶链反应（PCR）是诊断滴虫病的金标准，但成本高昂。抗原检测是检测阴道毛滴虫膜蛋白的免疫层析免疫测定法。尽管抗原检测使用方便且快速，但其诊断准确性仍不确定。因此，本荟萃分析旨在评估抗原检测对阴道毛滴虫感染的诊断准确性。
作者在PubMed、Embase和Cochrane图书馆数据库中检索评估抗原检测对阴道毛滴虫诊断准确性的研究。他们纳入提供诊断试验准确性数据的研究以进行荟萃分析。他们评估基于免疫层析和侧向流动装置的抗原检测。使用分层汇总接受者操作特征模型进行荟萃分析。
纳入11项研究，共5884个样本。荟萃分析得出合并灵敏度为87.0%，合并特异性为98.3%。以PCR作为参考标准的亚组分析得出灵敏度为58.5%，而另一项使用培养法的亚组分析得出灵敏度为95.9%。对来自有症状个体的2328个标本的6项研究进行亚组分析，得出合并灵敏度为85%，特异性为99.9%。
抗原检测显示出高灵敏度和特异性。此外，亚组分析表明，与无症状个体相比，抗原检测在诊断有症状患者时表现出更高的灵敏度。虽然抗原检测不如PCR敏感，但仍是检测阴道毛滴虫感染的一个有前景的途径。
