Wang Wei, Fan Xuzhou, Zhou Keyi, Chen Qianqian, Huang Xuelian
Department of Laboratory, Suzhou Xiangcheng Centers for Disease Control and Prevention, Suzhou, China.
Department of Blood Transfusion, Medicine School of Medicine Jinling Hospital Nanjing University, Nanjing, China.
Ann Med. 2025 Dec;57(1):2454327. doi: 10.1080/07853890.2025.2454327. Epub 2025 Jan 27.
Currently, there is a dearth of systematic research data on the phenomenon of false-positive reactions in treponemal tests. The aim of this study is to analyze the clinical characteristics and influencing factors associated with false-positive treponemal tests in patients, so as to enhance the diagnostic accuracy of syphilis and mitigate misdiagnosis-induced incorrect treatment.
From January 2017 to December 2023, a total of 759 cases with false-positive results for treponema were screened for blood transfusion, surgery, or other medical interventions at Jinling hospital. The demographic, clinical, and laboratory characteristics of patients were retrospectively analyzed to identify the risk factors associated with false-positive reactions in treponemal antibody screening.
The results indicated that individuals under 18 years old, over 45 years old and males exhibited a higher false-positive rate for treponemal tests ( < 0.001). The false-positive rates of treponema were found to be higher in the fields of pediatrics, nephrology, and internal medicine ( < 0.05). There was no difference observed in ABO blood group distribution ( > 0.05). .Furthermore, the levels of treponema antibody and coagulation function were found to be associated with the occurrence of false-positive syphilis test results. Multivariate logistic regression analysis indicated that ≤18 years, ≥45 years, male were independent risk factors ( < 0.01).
This study demonstrates that the false-positive rate of treponemal tests can be increased by factors such as age, gender, immune diseases, and coagulation disorders. The treponemal antibodies titer level is a valuable reference for assessing false-positive results. To enhance the accuracy of syphilis diagnosis, multiple risk factors should be considered when interpreting results from treponemal tests.
目前，关于梅毒螺旋体检测中假阳性反应现象的系统研究数据匮乏。本研究旨在分析患者梅毒螺旋体检测假阳性的临床特征及影响因素，以提高梅毒诊断准确性，减少误诊导致的不当治疗。
2017年1月至2023年12月，在金陵医院对759例梅毒螺旋体检测结果为假阳性的患者进行输血、手术或其他医疗干预筛查。回顾性分析患者的人口统计学、临床和实验室特征，以确定梅毒螺旋体抗体筛查中假阳性反应的相关危险因素。
结果表明，18岁以下、45岁以上人群及男性梅毒螺旋体检测假阳性率较高（<0.001）。梅毒螺旋体假阳性率在儿科、肾病科和内科领域较高（<0.05）。ABO血型分布未见差异（>0.05）。此外，发现梅毒螺旋体抗体水平和凝血功能与梅毒检测假阳性结果的发生有关。多因素logistic回归分析表明，≤18岁、≥45岁、男性是独立危险因素（<0.01）。
本研究表明，年龄、性别、免疫疾病和凝血障碍等因素可增加梅毒螺旋体检测的假阳性率。梅毒螺旋体抗体滴度水平是评估假阳性结果的重要参考。为提高梅毒诊断准确性，在解读梅毒螺旋体检测结果时应考虑多种危险因素。
