Zartarian M, Peterson E M, de la Maza L M
Department of Pathology, University of California Irvine, Medical Center, Orange 92668-4805, USA.
Am J Clin Pathol. 1997 Feb;107(2):148-53. doi: 10.1093/ajcp/107.2.148.
Two hundred twenty-six specimens (160 serum samples, 66 cerebrospinal fluid samples) were tested with the Meridian Premier Coccidioides enzyme immunoassay (MPC-EIA), and the results were compared with those of conventional serologic tests detecting complement-fixing (CF) and tube precipitin (TP) antibodies. Of the 73 positive specimens by CF, 72 were positive by MPC-EIA (72 IgG positive, 48 IgM positive) and 1 was indeterminate. Of the 132 specimens negative by CF, 126 were negative by MPC-EIA, 3 were IgM positive only, and 3 were indeterminate. Of the three patients with specimens positive for IgM only, CF demonstrated seroconversion within a month in one. All 21 specimens that displayed anticomplementary activity by CF were confirmed negative by agar gel immunodiffusion for CF antibodies (IDCF) and TP antibodies (IDTP); 20 of these serum samples were also negative by MPC-EIA, and 1 was indeterminate. After exclusion of the 25 specimens with anticomplementary or indeterminate activity, results of MPC-EIA were in agreement with those of CF in 99% of specimens. With CF as reference, MPC-EIA had a specificity of 98%, sensitivity of 100%, and positive and negative predictive values of 96% and 100%, respectively. Correlation coefficient values from linear regressions of log-2 CF titer vs MPC-EIA IgG index values were calculated at .290 for serum samples and .931 for cerebrospinal fluid.
采用Meridian Premier球孢子菌酶免疫测定法（MPC-EIA）检测了226份标本（160份血清样本，66份脑脊液样本），并将结果与检测补体结合（CF）和试管沉淀素（TP）抗体的传统血清学检测结果进行比较。在73份CF检测呈阳性的标本中，72份MPC-EIA检测呈阳性（72份IgG阳性，48份IgM阳性），1份结果不确定。在132份CF检测呈阴性的标本中，126份MPC-EIA检测呈阴性，3份仅IgM阳性，3份结果不确定。在仅标本IgM呈阳性的3例患者中，1例CF检测显示在1个月内血清转化。所有21份CF检测显示具有抗补体活性的标本，经琼脂凝胶免疫扩散检测CF抗体（IDCF）和TP抗体（IDTP）均确认为阴性；其中20份血清样本MPC-EIA检测也呈阴性，1份结果不确定。排除25份具有抗补体或结果不确定活性的标本后，MPC-EIA检测结果与CF检测结果在99%的标本中一致。以CF检测为参照，MPC-EIA检测的特异性为98%，敏感性为100%，阳性预测值和阴性预测值分别为96%和100%。血清样本log-2 CF滴度与MPC-EIA IgG指数值线性回归的相关系数值为0.290，脑脊液样本为0.931。
