以PCR與Flow cytometry進行HLA B27檢測之相關性對比

Comparison of Detection of HLA-B27 Antigen by Flow Cytometry and PCR

譚小雲(Sio-Wan Tam)

指導教授 ： 邱慧玲 ； 古勤

中山醫學大學/醫學科技學院/醫學檢驗暨生物技術學系碩士班/碩士(2018年)

摘要

HLA-B27除了對僵直性脊柱炎的診斷有價值外，還對其他疾病有著重要的意義，如: 銀屑病關節炎、反應性關節炎、骶髂關節炎、葡萄膜炎等。此論文主要目的是以文獻探討方式檢視序列特異性引物—聚合酶鏈反應(PCR—SSP)法、流式細胞分析(Flow Cytometry; FCM)法檢測血清人類白細胞抗原B27 (HLA—B27)對僵直性脊柱炎的診斷價值。主要探討的論文是將58例確診的僵直性脊柱炎患者作為觀察組，58例健康體檢者作為對照組，採用PCR—SSP法及FCM法檢測血清HLA—B27，其靈敏度分別為96.55％、93.10％，特異度分別為94.83％、91.38％; 兩種方法均有較高的靈敏度及特異度，差異無統計學意義(P>0.05);陽性預測值分別為94.92％、91.53％，陰性預測值分別為96.49％、92.98％。兩種方法均有較高的陽性預測值及陰性預測值，差異均無統計學意義(P>0.05)。結論：兩種檢測方法對診斷僵直性脊椎炎均有較高的特異度和陽性預測值，相較於FCM法，PCR—SSP法具有較高靈敏度、特異度、陽性預測值和陰性預測值。

關鍵字

僵直性脊柱炎 ； 聚合酶鏈式反應 ； 流式細胞儀 ； HLA—B27 ； 比較分析

並列摘要

Results of HLA-B27 detection can also provide useful information for the diagnosis of spondyloarthritis. It also help in the diagnosis of Psoriatic arthritis, Reactive arthritis, Sacroiliitis and Uveitis, etc. This paper reviews the ability of detecting HLA-B27 with PCR-SSP method and Flow cytometry (FCM) method in the diagnosis of ankylosing spondylitis (AS)．The paper published in 2014 selected 58 cases of AS patients as the observation group and 58 healthy subjects as the control group. HLA-B27 was detected respectively using the PCR-SSP method and FCM method to obtain a sensitivity for AS of 96.55% and 93.10% respectively while the specificity was 94.83% and 91.38%. There is no significant difference in sensitivity and specificity between these two methods (p>0.05); the positive predictive values were 94.92％ and 91.53％ and the negative predictive values were 96.49％ and 92.98％, respectively. There is no significant difference in positive predictive value and negative predictive values between these two methods (p>0.05). Conclusion: Both detection methods had a high specificity and positive predictive value in the diagnosis of AS. Although the difference is not statistically significant, PCR- SSP seems to have a higher sensitivity, specificity, positive predictive value and negative predictive value.

並列關鍵字

spondylitis ； ankylosing ； polymerase chain reaction ； flow cytometry ； HLA-B27 ； Comparative analysis

參考文獻

【01】Brewerton DA，Cafrey M，Hart FD，et a1．Ankylosing

Spondylitis and HLA-B27[J]．Lancet，1973，27(9)：904

【02】BIN CHEN, JIA LI, CHONGRU HE, DAHE LI, WENWEN TONG, YUMING ZOU and WEIDONG XU，Role of HLA-B27 in the pathogenesis of ankylosing spondylitis (Review)，MOLECULAR MEDICINE REPORTS， 2017，15: 1943-1951

【03】王平均，孫靈迪，武曉茜，邵先安，HLA—B27表達量在評估

強直性脊柱炎患者疾病狀況中的作用[J]，現代檢驗醫學雜誌，2015,30(5)﹕153-156