A Comparison of Ligase Chain Reaction toPolymerase Chain Reaction in the Detection ofChlamydia trachomatisEndocervical Infections

[摘要] Objective:To compare the reliability of ligase chain reaction (LCR) to polymerase chain reaction (PCR) in detectingChlamydia trachomatisendocervical infections.Methods:We conducted a prospective study of 486 patients at risk for chlamydial infection of theendocervix. We obtained two endocervical specimens from each patient and used LCR and PCR todetectC. trachomatis. Discrepant results between the two techniques were resolved by repeat testingand by testing for the major outer membrane protein (MOMP) gene, if necessary. We determinedthe sensitivity, specificity, positive predictive value, and negative predictive value for each test, usingconcordant results or MOMP gene results as the “gold standard”.Results:Of the 486 patients, 42 (8.6%) had evidence ofC. trachomatisinfection after resolution ofdiscrepant results. Of the 42 true positive specimens, 41 were positive by initial LCR and 38 werepositive by initial PCR. Of the 444 true negative specimens, none had a positive initial LCR result,while 2 had a positive initial PCR test. Therefore, compared to the gold standard, LCR had asensitivity of 97.6% and specificity of 100%, while PCR had a sensitivity of 90% and a specificity of99.5%. The positive and negative predictive values of LCR were 100% and 99.8%, respectively.PCR had a positive predictive value of 95% and a negative predictive value of 99.1%. The differencein sensitivity of LCR versus PCR was not statistically significant (P= .125).Conclusion:LCR and PCR perform equally well in detectingC. trachomatisendocervical infections.

[学科分类] 妇产科学