Performance Evaluation of CLIA for Treponema Pallidum Specific Antibodies Detection in Comparison with ELISA

In this study we aimed to evaluate the performance effects of chemiluminescence assay (CLIA) for Treponema pallidum specific antibodies detection, and to compare T. pallidum specific antibodies detection accuracy between CLIA and ELISA with TPPA (T. pallidum particle agglutination assay) as a confirmatory test.

A total of 865 samples from suspected syphilis patients and preoperative patients were included, in which T. pallidum specific antibodies were simultaneously detected by CLIA and ELISA. Among them, 457 samples were determined by TPPA.

All coefficients of variation (CVs) of ELISA in high-, median-, and low-level samples were more than 5% and the maximum CV was 54.39% in the low-level sample. CVs of CLIA in different-level samples were all below 5%. Among the three assays the Spearman correlation and Kappa coefficients were 0.771 (P ≤ 0.001) and 0.854 (P ≤ 0.001, CLIA vs. ELISA), 0.806 (P ≤ 0.001) and 0.897 (P ≤ 0.001, ELISA vs. TPPA), 0.937 (P ≤ 0.001) and 0.967 (P ≤ 0.001, CLIA vs. TPPA), respectively. The area under the receiver operating characteristic curve (AUC) of CLIA was higher than that of ELISA (0.994 vs. 0.989) with TPPA as the confirmatory test. In 18 discrepant samples the consistency rate between CLIA and TPPA was elevated compared with that between ELISA and TPPA (72.22% vs. 27.78%, P = 0.008). In gray zone, the consistency rate of CLIA with TPPA was higher than that of ELISA with TPPA (90.91% vs. 41.67%, P = 0.027).

Compared with ELISA, CLIA is more reliable, sensitive and accurate to detect serum T. pallidum specific antibodies. In the future it may be an alternative test with higher sensitivity to ELISA.