Analysis of the combined application of different syphilis serological tests

Objective To evaluate the significance of the combined application of different syphilis serological tests. Methods A total of 285 patients with syphilis were enrolled as syphilis group,and 150 patients without syphilis at the same period in Department of Surgery were enrolled as control group. Their serum samples were determined by treponema pallidum-enzyme-linked immunosorbent assay(TP-ELISA),rapid plasma reagin(RPR)test and treponema pallidum particle assay(TPPA). The significance of 3 single determinations and combined determination was compared. Results For primary syphilis,secondary syphilis,latent syphilis and control groups,the positive rates of these 3 methods had statistical significance(P < 0.05). The sensitivities of TP-ELISA,RPR test and TPPA were 93.68%,82.46% and 97.54%. The specificities were 99.33%,98.00% and 100.00%. The accuracies were 95.63%,87.82% and 98.39%. The combined determination improved the sensitivity and accuracy,and the combined determination of TP-ELISA,RPR test and TPPA had the highest sensitivity and accuracy(98.95% and 99.31%). Conclusions The combined determination of different syphilis serological tests can improve the accuracy in syphilis determination. For ensuring the accuracy of clinical diagnosis with no misdiagnosis and missed diagnosis,it is advisable to screen specimens by TP-ELISA in clinic and retest the suspected specimens by the combined determination of RPR test and TPPA.