Diagnostic Value of Em18 by Enzyme-linked Immunosorbent Assay (ELISA) in Alveolaris Echinococcosis: A systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

MENG Cunren , ZHANG Qiong ,  ZHANG Zhaoxia

The Medical Laboratory Center of the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;

Corresponding author：

ZHANG Zhaoxia, Email: mcr_123@163.com

Keywords：

Alveolaris echinococcosis; Em18 antigen; ELISA; Systematic review; Meta analysis

DOI：

10.7507/1672-2531.20090136

Video：

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Objective 　To evaluate the diagnostic value of Em18 by enzyme-linked immunosorbent assay (ELISA) in the patients with alveolaris echinococcosis (AE).
Methods 　We searched MEDLINE, EMBase, PubMed, The Cochrane Library, and other databases to collect the studies which evaluated the diagnostic value of Em18 in the patients with AE. QUADAS items were used to evaluate the quality of the included studies. The heterogeneity of the included studies and meta-analyses was analyzed by using RevMan 4.2.10. The Summary Recevier Operating Characteristic (SROC) curve was performed by meta-disc.
Results 　Eight studies involving 409 patients with AE diagnosed by the gold standard, 1105 patients with other diseases, and 216 healthy people were included. Meta analyses showed that the pooled sensitivity and pooled specificity of purified Em18 in ELISA were 91.5% and 91.7%, and those of recombinant Em18 were 92.2% and 95.7%, respectively. The AUC of SROC of purified Em18 and recombinant Em18 were 0.966 6 and 0.978 9, respectively.
Conclusion 　Purified Em18 and recombinant Em18 have high value in diagnosis of AE by ELISA.

Citation： MENG Cunren,ZHANG Qiong,ZHANG Zhaoxia. Diagnostic Value of Em18 by Enzyme-linked Immunosorbent Assay (ELISA) in Alveolaris Echinococcosis: A systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(7): 783-787. doi: 10.7507/1672-2531.20090136 Copy

1.	Eckert J, Schantz P, Gasser R, et al. Geographic distribution and prevalence. In:Eckert J, Gemmell MA, Meslin FX, et al, eds. WHOI/ OIE manual on echinococcosis in humans and animals:a public health problem of global concern. Paris: World Organization for Animal Health, 2001. 100-141.
2.	Zhang WB, Li J, McManus DP, et al. Concepts in immunology and diagnosis of hydatid disease. Clinical Microbiology Review, 2003, 16(1): 18-36.
3.	Eckerta J, Conrathsb FJ, Tackmannb K, et al. Echinococcosis :an emerging or reemerging zoonosis? International Journal for Parasitology, 2000, 30: 1283-1294.
4.	McManus DP, Zhang WB, Li J, et al. Echinococcosis. Lancet, 2003, 362: 1295-1304.
5.	Ito A, Nakao M, Kutsumi H. Serodiagnosis of alveolar hydatid disease by western bloting. Trans R Soc Trop Med Hyg, 1993, 87: 170-172.
6.	Whiting P, Rutjes AW, Reitsma JB, 等. QUADAS的制定: 用于系统评价中评价诊断性研究质量的工具(译文).中国循证医学杂志, 2007, 7(4): 296-306.
7.	Whiting P, Weswood ME, Rutjes AW, 等. QUADAS评价: 一种用于诊断性研究的质量评价工具 (修订版) (译文). 中国循证医学杂志, 2007, 7(7): 531-536.
8.	Jiang L, Wen H, Ito A. Immunodiagnostic differentiation of alveolar and cystic echinococcosis using ELISA test with 18-kDa antigen extracted from Echinococcus protoscoleces. Transactions of the Royal Society of Tropical Medicine & Hygiene, 2001, 95(3): 285-288.
9.	Ito A, Ma L, Itoh M, et al. Immunodiagnosis of alveolar echinococcosis by enzyme-linked immunosorbent assay using a partially purified Em18/16 enriched fraction. Clin Diagn Lab Immunol, 1997, 4(1): 57-59.
10.	Ito A, Xiao N, Liance M, et al. Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test. J Clin Microbiol, 2002, 40(11): 4161-4165.　.
11.	Sako Y, Nakao M, Nakaya K, et al. Alveolar echinococcosis:characterization of diagnostic antigen Em18 and serological evaluation of recombinant Em18. Journal of Clinical Microbiology, 2002: 2760-2765.
12.	Xiao N, Mamuti W, Yamasaki H, et al. Evaluation of use of recombinant Em18 and affinity-purified Em18 for serological differentiation of alveolar echinococcosis from cystic echinococcosis and other parasiticinfections. J Clin Microbiol, 2003, 41(7): 3351-3353.
13.	王俨. 泡球蚴Em18抗原基因的克隆、原核表达及其免疫诊断价值的研究. 中国优秀硕士学位论文全文数据库.
14.	江莉, 冯正, 薛海筹, 等. 多房棘球蚴病特异性诊断抗原Em18的基因克隆、表达和血清学评价. 中国寄生虫学与寄生虫病杂志, 2004, 22(4): 193-198.
15.	林仁勇, 张春桃, 温浩, 等. Eml8.3重组蛋白的表达及其免疫诊断特性的研究. 新疆医科大学学报, 2007, 30(4): 332-335.
16.	李淑萍, 陈雅棠, 余登高, 等. 多房棘球绦虫原头节蛋白抗原的免疫诊断价值. 中国寄生虫学与寄生虫病杂志, 2001, 19(1): 56-57.
17.	王俨, 林仁勇, 丁剑冰, 等. 泡球蚴EM18重组蛋白的表达及其抗原性检测的研究. 中国寄生虫病防治杂志, 2005, 18(1): 33-36.

1. Eckert J, Schantz P, Gasser R, et al. Geographic distribution and prevalence. In:Eckert J, Gemmell MA, Meslin FX, et al, eds. WHOI/ OIE manual on echinococcosis in humans and animals:a public health problem of global concern. Paris: World Organization for Animal Health, 2001. 100-141.
2. Zhang WB, Li J, McManus DP, et al. Concepts in immunology and diagnosis of hydatid disease. Clinical Microbiology Review, 2003, 16(1): 18-36.
3. Eckerta J, Conrathsb FJ, Tackmannb K, et al. Echinococcosis :an emerging or reemerging zoonosis? International Journal for Parasitology, 2000, 30: 1283-1294.
4. McManus DP, Zhang WB, Li J, et al. Echinococcosis. Lancet, 2003, 362: 1295-1304.
5. Ito A, Nakao M, Kutsumi H. Serodiagnosis of alveolar hydatid disease by western bloting. Trans R Soc Trop Med Hyg, 1993, 87: 170-172.
6. Whiting P, Rutjes AW, Reitsma JB, 等. QUADAS的制定: 用于系统评价中评价诊断性研究质量的工具(译文).中国循证医学杂志, 2007, 7(4): 296-306.
7. Whiting P, Weswood ME, Rutjes AW, 等. QUADAS评价: 一种用于诊断性研究的质量评价工具 (修订版) (译文). 中国循证医学杂志, 2007, 7(7): 531-536.
8. Jiang L, Wen H, Ito A. Immunodiagnostic differentiation of alveolar and cystic echinococcosis using ELISA test with 18-kDa antigen extracted from Echinococcus protoscoleces. Transactions of the Royal Society of Tropical Medicine & Hygiene, 2001, 95(3): 285-288.
9. Ito A, Ma L, Itoh M, et al. Immunodiagnosis of alveolar echinococcosis by enzyme-linked immunosorbent assay using a partially purified Em18/16 enriched fraction. Clin Diagn Lab Immunol, 1997, 4(1): 57-59.
10. Ito A, Xiao N, Liance M, et al. Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test. J Clin Microbiol, 2002, 40(11): 4161-4165.　.
11. Sako Y, Nakao M, Nakaya K, et al. Alveolar echinococcosis:characterization of diagnostic antigen Em18 and serological evaluation of recombinant Em18. Journal of Clinical Microbiology, 2002: 2760-2765.
12. Xiao N, Mamuti W, Yamasaki H, et al. Evaluation of use of recombinant Em18 and affinity-purified Em18 for serological differentiation of alveolar echinococcosis from cystic echinococcosis and other parasiticinfections. J Clin Microbiol, 2003, 41(7): 3351-3353.
13. 王俨. 泡球蚴Em18抗原基因的克隆、原核表达及其免疫诊断价值的研究. 中国优秀硕士学位论文全文数据库.
14. 江莉, 冯正, 薛海筹, 等. 多房棘球蚴病特异性诊断抗原Em18的基因克隆、表达和血清学评价. 中国寄生虫学与寄生虫病杂志, 2004, 22(4): 193-198.
15. 林仁勇, 张春桃, 温浩, 等. Eml8.3重组蛋白的表达及其免疫诊断特性的研究. 新疆医科大学学报, 2007, 30(4): 332-335.
16. 李淑萍, 陈雅棠, 余登高, 等. 多房棘球绦虫原头节蛋白抗原的免疫诊断价值. 中国寄生虫学与寄生虫病杂志, 2001, 19(1): 56-57.
17. 王俨, 林仁勇, 丁剑冰, 等. 泡球蚴EM18重组蛋白的表达及其抗原性检测的研究. 中国寄生虫病防治杂志, 2005, 18(1): 33-36.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Em18 by Enzyme-linked Immunosorbent Assay (ELISA) in Alveolaris Echinococcosis: A systematic Review

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