Comparisons of several laboratory tests in the diagnosis of neurosyphilis

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Author:
LIN Lu-yang(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
LI Ji(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
WANG Huan-li(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
ZHONG Dao-qing(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
YANG Ri-dong(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
ZHANG Xi-bao(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
XU Lin()
SONG Wei-zhong(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
BI Chao(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
LIANG Yan-hua(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
LI Yang-qi(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
CAO Wen-ling(Guangzhou Institute of Dermatology, Guangzhou STDs Surveillance Centre, Guangzhou 510095, China)
Journal Title:
CHINESE JOURNAL OF DERMATOLOGY
Issue:
Volume 44, Issue 02, 2011
DOI:
10.3760/cma.j.issn.0412-4030.2011.02.019
Key Word:
Neurosyphilis;Syphilis serodiagnosis;Sensitivity and specificity;Area under curve

Abstract: Objective To compare the sensitivity and specificity of venereal disease research laboratory (VDRL) test versus several other laboratory tests in the diagnosis of neurosyphilis. Methods Lumber puncture was conducted to obtain cerebrospinal fluid (CSF) from untreated outpatients with latent syphilis (LS) or serofast outpatients with LS. Then, VDRL test, rapid plasma regain (RPR) test, Treponema pallidum particle agglutination (TPPA) assay, fluorescent treponemal antibody-absorption (FTA-ABS) test and protein quantification were performed on these CSF samples. The sensitivity, specificity, positive predictive value and negative predictive value were compared between VDRL test and four other laboratory tests in the diagnosis of neurosyphilis. Results Totally, 61 cases of latent syphilis were included in this study. The sensitivity, specificity,positive predictive value and negative predictive value were 93.44% (57/61), 99.32%(293/295), 96.61%(57/59), 98.65% (293/297)for CSF-RPR, respectively, 91.80% (56/61), 82.71% (244/295), 52.34% (56/107),97.99 (244/249) for CSF-TPPA, respectively, 93.44% (57/61), 82.71% (244/295), 52.78%(57/108), 98.39%(244/248) for CSF-FTA-ABS, respectively, and 49.18%(30/61), 97.29% (287/295), 78.95% (30/38),90.25% (287/318) for CSF protein quantification, respectively. Conclusions CSF-VDRL cannot be replaced by CSF-RPR, -TPPA, -FTA-ABS, or CSF protein quantification in the diagnosis of neurosyphilis. CSF-RPR shows a high sensitivity and specificity in the diagnosis of neurosyphilis, with an increased diagnostic capability (area under the receiver operating characteristic curve) compared with CSF-TPPA, CSF-FTA-ABS or CSF protein quantification.

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