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Abstract：
Nontreponemal and treponemal tests for analyzing cerebrospinal fluid to confirm the existence of neurosyphilis have been widely used, so we aim to evaluate and compare their performance on the cerebrospinal fluid in the diagnosis of neurosyphilis.
We conducted a systematic literature search on five databases and utilized a bivariate random-effects model to perform the quantitative synthesis.
Nontreponemal tests demonstrated a pooled sensitivity of 0.77 (95% CI: 0.68-0.83), a pooled specificity of 0.99 (95% CI: 0.97-1.00), and a summary AUC of 0.97 (95% CI: 0.95-0.98). The pooled sensitivity, pooled specificity, and summary AUC of treponemal tests were 0.95 (95% CI: 0.90-0.98), 0.85 (95% CI: 0.67-0.94), and 0.97 (95% CI: 0.95-0.98), respectively. The pooled specificity of all nontreponemal tests varied minimally (ranging from 0.97 to 0.99), with TRUST (0.83) having a higher pooled sensitivity than VDRL (0.77) and RPR (0.73). Among all treponemal tests, EIA has outstanding diagnostic performance with a pooled sensitivity of 0.99 and a pooled specificity of 0.98.
Nontreponemal tests exhibited a higher pooled specificity, and treponemal tests exhibited a higher pooled sensitivity in diagnosing neurosyphilis on cerebrospinal fluid. TRUST may be a satisfactory substitute for VDRL. EIA is a prospective diagnostic tool that deserves further study in the future. Our study may be useful to clinical laboratories in selecting appropriate serological tests on the cerebrospinal fluid for the diagnosis of neurosyphilis.
We conducted a systematic literature search on five databases and utilized a bivariate random-effects model to perform the quantitative synthesis.
Nontreponemal tests demonstrated a pooled sensitivity of 0.77 (95% CI: 0.68-0.83), a pooled specificity of 0.99 (95% CI: 0.97-1.00), and a summary AUC of 0.97 (95% CI: 0.95-0.98). The pooled sensitivity, pooled specificity, and summary AUC of treponemal tests were 0.95 (95% CI: 0.90-0.98), 0.85 (95% CI: 0.67-0.94), and 0.97 (95% CI: 0.95-0.98), respectively. The pooled specificity of all nontreponemal tests varied minimally (ranging from 0.97 to 0.99), with TRUST (0.83) having a higher pooled sensitivity than VDRL (0.77) and RPR (0.73). Among all treponemal tests, EIA has outstanding diagnostic performance with a pooled sensitivity of 0.99 and a pooled specificity of 0.98.
Nontreponemal tests exhibited a higher pooled specificity, and treponemal tests exhibited a higher pooled sensitivity in diagnosing neurosyphilis on cerebrospinal fluid. TRUST may be a satisfactory substitute for VDRL. EIA is a prospective diagnostic tool that deserves further study in the future. Our study may be useful to clinical laboratories in selecting appropriate serological tests on the cerebrospinal fluid for the diagnosis of neurosyphilis.
摘要：
UNASSIGNED：用于分析脑脊液以确认神经梅毒存在的非螺旋体和螺旋体测试已被广泛使用，因此，我们旨在评估和比较它们在脑脊液中的表现在神经梅毒的诊断中。
UNASSIGNED：我们在五个数据库上进行了系统的文献检索，并利用双变量随机效应模型进行了定量合成。
未经评估：非密螺旋体检验显示出0.77的合并敏感性（95％CI：0.68-0.83），合并特异性为0.99(95%CI：0.97-1.00)，和总结AUC为0.97（95%CI：0.95-0.98）。汇集的敏感性，汇集特异性，螺旋体试验的总结AUC为0.95（95％CI：0.90-0.98），0.85（95%CI：0.67-0.94），和0.97（95%CI：0.95-0.98），分别。所有非密螺旋体试验的合并特异性变化最小（范围从0.97到0.99），TRUST（0.83）的合并敏感性高于VDRL（0.77）和RPR（0.73）。在所有密螺旋体测试中，EIA具有出色的诊断性能，合并灵敏度为0.99，合并特异性为0.98。
未经评估：非密螺旋体试验表现出更高的合并特异性，和密螺旋体试验在诊断脑脊液神经梅毒方面表现出更高的合并敏感性。TRUST可能是VDRL的令人满意的替代品。EIA是一种未来值得进一步研究的前瞻性诊断工具。我们的研究可能有助于临床实验室在脑脊液中选择适当的血清学检查以诊断神经梅毒。
UNASSIGNED：我们在五个数据库上进行了系统的文献检索，并利用双变量随机效应模型进行了定量合成。
未经评估：非密螺旋体检验显示出0.77的合并敏感性（95％CI：0.68-0.83），
未经评估：非密螺旋体试验表现出更高的合并特异性，
