应用ROC曲线设置梅毒抗体检测灰区的探讨

Investigation on determining gray zone of syphilis antibody detection using ROC curve analysis

目的 :应用受试者工作特征曲线(ROC曲线)分析设置磁微粒化学发光法检测梅毒抗体的灰区,提高检测的准确性,为临床提供可靠的实验室依据。方法 :回顾性分析某院10350例梅毒血清样本检测结果,样本均采用AutoLumo A2000化学发光仪检测梅毒抗体,留取S/CO值介于1~35之间的样本,进行TPPA试验和TRUST试验。结合临床资料、TPPA试验和TRUST试验结果,筛选结果可靠的样本,绘制ROC曲线图。根据ROC曲线分析结果,利用直线内插法,设置并计算灰区的上下限。结果 :根据ROC曲线分析设置磁微粒化学发光法检测梅毒抗体的灰区为8.64~23.237。结论 :应用ROC曲线分析设置灰区的方法较理想,可避免不必要的复检和保证灰区样本结果的可靠性。

Objective To determine the gray zone of syphilis antibody detection of magnetic particle chemiluminescence method using receiver operating characteristic(ROC)curve analysis in order to improve the accuracy and reliability of testing in clinical practice.Methods The syphilis antibody detecting results of 10350 sera samples tested by AutoLumo A2000 chemiluminescence tester in a hospital were analyzed retrospectively.The sera samples with the S/CO values between 1 and 35 were collected and retested by treponema pallidum gelatin particle agglutination test(TPPA)and toluidine red unheated serum reagin test(TRUST).Combined the clinical symptoms and the results of the TPPA test and TRUST test,the samples with reliable results were screened and the ROC curve analysis was performed.According to the results of the ROC curve analysis,the upper and lower limits of the gray zone were determined and calculated by method of linear interpolation.Results The gray zone of syphilis antibody detected by magnetic particle chemiluminescence method was between 8.64 and 23.237 according to the ROC curve analysis.Conclusion The ROC curve analysis is an ideal method to calculate the gray zone,which can avoid unnecessary re-inspection and ensure the reliability of results of the gray zone samples.