Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Province, China.
World J Gastroenterol. 2013 Mar 14;19(10):1645-51. doi: 10.3748/wjg.v19.i10.1645.
To investigate the performance and diagnostic accuracy of interferon-gamma (IFN-γ) for tuberculous peritonitis (TBP) by meta-analysis.
A systematic search of English language studies was performed. We searched the following electronic databases: MEDLINE, EMBASE, Web of Science, BIOSIS, LILACS and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IFN-γ concentration in the diagnosis of peritoneal effusion were pooled using random-effects models. Receiver operating characteristic (ROC) curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.
Six studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92. Analysis of IFN-γ level for TBP diagnosis yielded a summary estimate: sensitivity, 0.93 (95%CI, 0.87-0.97); specificity, 0.99 (95%CI, 0.97-1.00); positive likelihood ratio (PLR), 41.49 (95%CI, 18.80-91.55); negative likelihood ratio (NLR), 0.11 (95%CI, 0.06-0.19); and diagnostic odds ratio (DOR), 678.02 (95%CI, 209.91-2190.09). χ(2) values of the sensitivity, specificity, PLR, NLR and DOR were 5.66 (P = 0.3407), 6.37 (P = 0.2715), 1.38 (P = 0.9265), 5.46 (P = 0.3621) and 1.42 (P = 0.9220), respectively. The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97. The area under the curve was 0.99. The evaluation of publication bias was not significant (P = 0.922).
IFN-γ may be a sensitive and specific marker for the accurate diagnosis of TBP. The level of IFN-γ may contribute to the accurate differentiation of tuberculosis (TB) ascites from non-TB ascites.
通过荟萃分析研究干扰素-γ（IFN-γ）在结核性腹膜炎（TBP）中的性能和诊断准确性。
系统检索英文文献。我们检索了以下电子数据库：MEDLINE、EMBASE、Web of Science、BIOSIS、LILACS 和 Cochrane 图书馆。使用诊断准确性研究的报告标准和质量评估工具来评估研究的方法学质量。使用随机效应模型汇总 IFN-γ浓度在诊断腹膜液中的准确性的敏感性、特异性和其他指标。应用受试者工作特征（ROC）曲线总结总体测试性能。两位审阅者独立判断研究资格，同时筛选引文。
六项研究符合纳入标准。两位审阅者对质量检查表中各项的平均组内一致性为 0.92。对 TBP 诊断的 IFN-γ水平进行分析得出综合估计值：敏感性为 0.93（95%CI，0.87-0.97）；特异性为 0.99（95%CI，0.97-1.00）；阳性似然比（PLR）为 41.49（95%CI，18.80-91.55）；阴性似然比（NLR）为 0.11（95%CI，0.06-0.19）；诊断比值比（DOR）为 678.02（95%CI，209.91-2190.09）。敏感性、特异性、PLR、NLR 和 DOR 的 χ²值分别为 5.66（P = 0.3407）、6.37（P = 0.2715）、1.38（P = 0.9265）、5.46（P = 0.3621）和 1.42（P = 0.9220）。综合接收者 ROC 曲线位于理想的左上角附近，最大联合敏感性和特异性为 0.97。曲线下面积为 0.99。对发表偏倚的评估不显著（P = 0.922）。
IFN-γ 可能是 TBP 准确诊断的敏感和特异标志物。IFN-γ 水平可能有助于准确区分结核性腹水和非结核性腹水。
