The Diagnostic Performance of Laboratory Tests of Neurosyphilis: A Systematic Review and Network Meta-Analysis.

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY European Neurology Pub Date : 2023-01-01 Epub Date: 2023-08-07 DOI:10.1159/000531341

Duyu Ding, Junhua Gao, Wei Zhang, Dongmei Xu

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Abstract

Introduction: The gold standard for diagnosing neurosyphilis (NS) is currently unavailable; various laboratory parameters in cerebrospinal fluid (CSF) and blood can assist in the diagnosis.

Methods: PubMed, Embase, and the Cochrane Library were searched. Studies utilizing laboratory tests to assist in the diagnosis of NS were included. The pooled indicators for diagnostic performance and their respective 95% confidence intervals (CIs) were calculated. We used the superiority index to test the superiority of a diagnostic test.

Results: Eleven citations were included in the study. Albumin quotient, CSF-TPHA, CSF-EIA, CSF-LDH, CSF-WBC, CSF-CXCL13, FTA-ABS, CSF-PCR, RPR, CSF-TPPA, TRUST, and CSF-venereal diseases research laboratory (VDRL) were assessed in the studies included. The pooled estimates of sensitivity, specificity, AUC of SROC and their respective 95% CIs for CSF-TPPA and CSF-VDRL were 0.97 (0.17, 1.00), 0.84 (0.62, 0.95), 0.93 (0.91, 0.95) and 0.74 (0.59, 0.85), 0.99 (0.93, 1.00), 0.94 (0.91, 0.96), respectively. CSF-TPHA demonstrated the highest relative sensitivity. CSF-VDRL manifested the highest specificity. CSF-TPHA, TRUST, CSF-VDRL, CSF-EIA, and RPR ranked in the top five laboratory tests with superiority index.

Conclusion: CSF-TPHA, TRUST, CSF-VDRL, CSF-EIA, and RPR indicate acceptable performance in detecting NS compared to other modalities. Comprehensive diagnostic strategies still play a significant role in the diagnosis of NS.

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神经梅毒实验室检测的诊断性能：系统回顾与网络元分析

简介：目前尚无诊断神经梅毒（NS）的金标准；脑脊液（CSF）和血液中的各种实验室指标可协助诊断：目前尚无诊断神经梅毒（NS）的金标准；脑脊液（CSF）和血液中的各种实验室参数可协助诊断：方法：检索了PubMed、Embase和Cochrane图书馆。方法：检索了 PubMed、Embase 和 Corane 图书馆，纳入了利用实验室检测辅助诊断 NS 的研究。计算了诊断性能的汇总指标及其各自的 95% 置信区间 (CI)。我们使用优越性指数来检验诊断测试的优越性：研究共纳入了 11 篇引文。白蛋白商、CSF-TPHA、CSF-EIA、CSF-LDH、CSF-WBC、CSF-CXCL13、FTA-ABS、CSF-PCR、RPR、CSF-TPPA、TRUST和CSF-性病研究实验室（VDRL）在纳入的研究中进行了评估。CSF-TPPA和CSF-VDRL的灵敏度、特异性、SROC的AUC及其各自的95%CI的集合估计值分别为0.97（0.17，1.00）、0.84（0.62，0.95）、0.93（0.91，0.95）和0.74（0.59，0.85）、0.99（0.93，1.00）、0.94（0.91，0.96）。CSF-TPHA 的相对灵敏度最高。CSF-VDRL 的特异性最高。CSF-TPHA、TRUST、CSF-VDRL、CSF-EIA 和 RPR 在实验室检测中的优越性指数排名前五：结论：与其他检测方法相比，CSF-TPHA、TRUST、CSF-VDRL、CSF-EIA 和 RPR 在检测 NS 方面的表现尚可接受。综合诊断策略在 NS 的诊断中仍发挥着重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Neurology 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

审稿时长

4-8 weeks

期刊介绍： ''European Neurology'' publishes original papers, reviews and letters to the editor. Papers presented in this journal cover clinical aspects of diseases of the nervous system and muscles, as well as their neuropathological, biochemical, and electrophysiological basis. New diagnostic probes, pharmacological and surgical treatments are evaluated from clinical evidence and basic investigative studies. The journal also features original works and reviews on the history of neurology.