Serological diagnosis of echinococcosis: the diagnostic potential of native antigens
Serological diagnosis of echinococcosis: the diagnostic potential of native antigens
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DOI：
10.1007/s15010-011-0205-6
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发表时间：
2012-04-01
期刊：
影响因子：
7.5
通讯作者：
Deplazes, P.
中科院分区：
文献类型：
--
作者：
Schweiger, A.;Grimm, F.;Deplazes, P.
多房棘球蚴和E.颗粒肌分别缺乏特异性临床体征。因此，诊断依赖于成像和血清学研究的结果。本研究的主要目的是评估几种易于生产的粗品或部分纯化的E。granulosus和E.将多房棘球蚴衍生抗原作为疑似AE或CE患者的血清学诊断和鉴别诊断的工具。51名未接受治疗的AE和32名CE患者、98名瑞士献血者和38名最初疑似棘球蚴病但患有各种其他肝脏疾病（例如，肝肿瘤等）根据酶联免疫吸附试验（ELISA）的结果，对E。细粒棘球蚴对CE和AE诊断的敏感性分别为81 ~ 97%和> 99.9%。E.多房后囊蚴对CE和AE诊断的敏感性分别为84 ~ 91%和> 99.9%。特异性范围为92%至> 99.9%。在瑞士，AE与肝肿瘤的鉴别诊断、CE与囊性肝病变的鉴别诊断以及AE筛查的检验后概率分别约为95%、86%和2.2%。与其他寄生虫病（片形吸虫病、绦虫病、阿米巴病、囊虫病和丝虫病）患者血清中的抗体交叉反应的频率不同，但可以通过使用确认试验消除。granulosus和E.多房棘球蚴是棘球蚴病血清学诊断的有价值、可广泛获得且具有成本效益的工具。然而，由于缺乏种属特异性和与其他蠕虫病发生交叉反应，确认试验是必要的。
Human alveolar (AE) and cystic echinococcosis (CE) caused by the metacestode stages of Echinococcus multilocularis and E. granulosus, respectively, lack pathognomonic clinical signs. Diagnosis therefore relies on the results of imaging and serological studies. The primary goal of this study was to evaluate the efficacy of several easy-to-produce crude or partially purified E. granulosus and E. multilocularis metacestode-derived antigens as tools for the serological diagnosis and differential diagnosis of patients suspicious for AE or CE.The sera of 51 treatment-na < ve AE and 32 CE patients, 98 Swiss blood donors and 38 patients who were initially suspicious for echinococcosis but suffering from various other liver diseases (e.g., liver neoplasia, etc.) were analysed.According to the results of enzyme-linked immunosorbent assays (ELISA), metacestode-derived antigens of E. granulosus had sensitivities varying from 81 to 97% and > 99.9% for the diagnosis of CE and AE, respectively. Antigens derived from E. multilocularis metacestodes had sensitivities ranging from 84 to 91% and > 99.9% for the diagnosis of CE and AE, respectively. Specificities ranged from 92 to > 99.9%. Post-test probabilities for the differential diagnosis of AE from liver neoplasias, CE from cystic liver lesions, and screening for AE in Switzerland were around 95, 86 and 2.2%, respectively. Cross-reactions with antibodies in sera of patients with other parasitic affections (fasciolosis, schistosomosis, amebosis, cysticercosis, and filarioses) did occur at variable frequencies, but could be eliminated through the use of confirmatory testing.Different metacestode-derived antigens of E. granulosus and E. multilocularis are valuable, widely accessible, and cost-efficient tools for the serological diagnosis of echinococcosis. However, confirmatory testing is necessary, due to the lack of species specificity and the occurrence of cross-reactions to other helminthic diseases.