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Objective:To explore the relationship between quantitative Treponema pallidum DNA (TP-DNA) PCR testing and the Toludine Red Unheated Serum Test (TRUST) in patients with syphilis before and after treatment, and evaluate the clinical value of quantitative TP-DNA testing in the diagnosis and treatment evaluation of syphilis.Methods: 29 patients with primary (12 cases) or secondary(17 cases) syphilis, who met the criteria set for this study were recruited as subjects. All patients were treated with 2.4 million units benzathine penicillin IM weekly for 3 weeks.Quantitative tests of TP-DNA in the patients’ plasma were performed using FQ-PCR before and after the treatment.Serologic tests including TRUST and TPPA were also performed.Results: Before the treatment, 9 out of 12 primary syphilis patients (75%) and all secondary syphilis patients (17/17)tested positive for Treponema pallidum (TP) by TP-DNA testing. The average quantitative test values of TP-DNA in primary and secondary syphilis patients were (3.38±2.34)×104 and (5.73±1.33)×106 copies/mi, respectively. After three months of treatment, 1 of the 9 primary and 5 out of 17 secondary syphilis patients were positive upon TP-DNA testing, respectively. The average quantities of TP-DNA were 2.01×102 copies/mi in primary and 5.87×102 copies/ml in secondary syphilis patients with positive TRUST and TP-DNA tests, and 3.09×102 copies/mi for those with negative TRUST,respectively. After nine months of treatment, all the primary and secondary syphilis patients were negative upon TP-DNA testing, while all primary and 14 of 17 (82.35%) secondary syphilis patients showed negative TRUST results.Conclusion: That the results of TP-DNA tests are not consistent with those of TRUST before and after treatment indicates that quantitative TP-DNA testing may have valuable clinical significance in the early diagnosis and evaluation of treatment regimens for syphilis.