Academic Journal
[Construction and Efficacy Evaluation of a Highly Efficient Diagnostic Model for Neurosyphilis Driven by the Cerebrospinal Fluid/Serum Free Light Chain Index].
| Title: | [Construction and Efficacy Evaluation of a Highly Efficient Diagnostic Model for Neurosyphilis Driven by the Cerebrospinal Fluid/Serum Free Light Chain Index]. |
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| Transliterated Title: | 脑脊液/血清游离轻链指数驱动神经梅毒高效诊断模型构建与效能评估. |
| Authors: | Deng J; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.; （ 610041）Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Wu S; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China., Ye F; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China., Huang X; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China., Li D; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China., Liu J; （ 646000）Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China. |
| Source: | Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition [Sichuan Da Xue Xue Bao Yi Xue Ban] 2026 Mar 20; Vol. 57 (2), pp. 448-454. |
| Publication Type: | English Abstract; Journal Article |
| Language: | Chinese |
| Journal Info: | Publisher: Sichuan da xue xue bao (yi xue ban) bian ji bu Country of Publication: China NLM ID: 101162609 Publication Model: Print Cited Medium: Print ISSN: 1672-173X (Print) Linking ISSN: 1672173X NLM ISO Abbreviation: Sichuan Da Xue Xue Bao Yi Xue Ban Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chengdu Shi : Sichuan da xue xue bao (yi xue ban) bian ji bu, 2003- |
| MeSH Terms: | Neurosyphilis*/diagnosis , Neurosyphilis*/cerebrospinal fluid , Neurosyphilis*/blood , Immunoglobulin kappa-Chains*/blood , Immunoglobulin kappa-Chains*/cerebrospinal fluid , Immunoglobulin lambda-Chains*/blood , Immunoglobulin lambda-Chains*/cerebrospinal fluid , Immunoglobulin Light Chains*/blood , Immunoglobulin Light Chains*/cerebrospinal fluid, Humans ; Male ; Adult ; Female ; Middle Aged |
| Abstract: | Objective: To determine free light chains (FLC) in cerebrospinal fluid (CSF) and serum, calculate the FLC index, and establish a model to evaluate its application value in diagnosing neurosyphilis. Methods: This study included 87 syphilis patients, comprising 48 neurosyphilis patients (NS group) and 39 non-neurosyphilis patients (n-NS group). CSF and serum samples were collected from all patients to measure kappa free light chains (FLC-κ) and lambda free light chains (FLC-λ). The FLC index, FLC-κ index, and FLC-λ index were calculated. Receiver operating characteristic (ROC) curves were used to evaluate these indices. A neurosyphilis diagnostic model based on the FLC index was established and its visualization was verified. Results: Statistically significant differences were observed between the two groups in serological syphilis screening, CSF nucleated cell count, CSF microprotein, CSF IgG, IgG synthesis rate, IgG index, and albumin quotient (P < 0.05). The areas under the ROC curves (AUC) for the FLC-κ index, FLC-λ index, and albumin quotient were 0.998 (95% CI: 0.990-1.000), 0.988 (95% CI: 0.961-1.000), and 0.635 (95% CI: 0.496-0.751), respectively. In the FLC-κ index model, the FLC-κ index (P < 0.05) significantly affected the diagnosis of neurosyphilis, while in the FLC-λ index model, only the FLC-λ index (P < 0.05) had a significant effect. The training ROC curve AUC for the diagnosis model based on the FLC-κ index was greater than 0.950. Its calibration curve showed good predictive performance when the predicted probability was close to 80%, but poor performance when the predicted probability was 40%-60%. The AUC for the diagnosis model based on the FLC-λ index was 0.926, with good predictive performance when the predicted probability was close to 85%, and poor performance when the predicted probability was 40%-70%. Conclusion: FLC-κ and FLC-λ have high diagnostic performance for neurosyphilis, and the FLC index has certain application value in the diagnosis of neurosyphilis. (© 2026《四川大学学报（医学版）》编辑部 Copyright © 2026 Editorial Office of Journal of Sichuan University (Medical Sciences).) |
| Competing Interests: | 所有作者均声明不存在利益冲突 |
| Contributed Indexing: | Keywords: Diagnostic model; Free light chains index; Kappa free light chains; Lambda free light chains; Neurosyphilis |
| Substance Nomenclature: | 0 (Immunoglobulin kappa-Chains) 0 (Immunoglobulin lambda-Chains) 0 (Immunoglobulin Light Chains) |
| Entry Date(s): | Date Created: 20260423 Date Completed: 20260715 Latest Revision: 20260715 |
| Update Code: | 20260716 |
| PubMed Central ID: | PMC13095775 |
| DOI: | 10.12182/20260360204 |
| PMID: | 42021880 |
| Database: | MEDLINE |
| ISSN: | 1672-173X |
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| DOI: | 10.12182/20260360204 |