Tong Xiaomeng, Lu Hongkai, Yu Min, Wang Guozhen, Han Chengwu, Cao Yongtong
Department of Laboratory Medicine and Department of Blood transfusion, China-Japan Friendship Hospital, Beijing 100029, China.
Department of Laboratory Medicine and Department of Blood transfusion, China-Japan Friendship Hospital, Beijing 100029, China.
Clin Chim Acta. 2017 Aug;471:143-149. doi: 10.1016/j.cca.2017.05.034. Epub 2017 May 31.
The accurate diagnosis of tuberculous pleurisy is still a clinical challenge. Many studies reported that interferon-γ-induced protein of 10kDa (IP-10) plays a role in diagnosing tuberculous pleurisy, but with considerable variance of results. This meta-analysis aimed to evaluate the overall diagnostic accuracy of IP-10 for tuberculous pleurisy.
PubMed, EMBASE, and other databases were searched for studies examining accuracy of pleural IP-10 for diagnosing tuberculous pleurisy. Related data were extracted and sensitivity/specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were pooled. Summary receiver operating characteristic curve and area under the curve (AUC) were performed and calculated to summarize the overall test performance.
Fourteen studies involving 1382 subjects met inclusion criteria, including 715 cases of tuberculous pleurisy and 667 controls. Summary estimates of the diagnostic performance of the IP-10 for tuberculous pleurisy were listed as follows: sensitivity, 0.84 (95%CI 0.81 to 0.87); specificity, 0.90 (95% CI 0.88 to 0.92); PLR, 7.96 (95% CI 5.59 to 11.32); NLR, 0.19 (95% CI 0.15 to 0.24); DOR, 49.82 (95% CI 28.08 to 88.38); and AUC 0.94. No publication bias was detected.
Pleural IP-10 is a useful diagnostic marker for tuberculous pleurisy. Nevertheless, its result should be interpreted together with the results of conventional test and clinical information of patients.
结核性胸膜炎的准确诊断仍是一项临床挑战。许多研究报告称,10 kDa干扰素γ诱导蛋白(IP-10)在结核性胸膜炎的诊断中发挥作用,但结果差异较大。本荟萃分析旨在评估IP-10对结核性胸膜炎的总体诊断准确性。
检索PubMed、EMBASE和其他数据库,查找有关胸膜IP-10诊断结核性胸膜炎准确性的研究。提取相关数据并汇总敏感性/特异性、阳性/阴性似然比(PLR/NLR)和诊断比值比(DOR)。绘制并计算汇总受试者工作特征曲线和曲线下面积(AUC),以总结总体检验性能。
14项研究共纳入1382名受试者,符合纳入标准,其中包括715例结核性胸膜炎患者和667例对照。IP-10对结核性胸膜炎诊断性能的汇总估计如下:敏感性为0.84(95%CI 0.81至0.87);特异性为0.90(95%CI 0.88至0.92);PLR为7.96(95%CI 5.59至11.32);NLR为0.19(95%CI 0.15至0.24);DOR为49.82(95%CI 28.08至88.38);AUC为0.94。未检测到发表偏倚。
胸膜IP-10是结核性胸膜炎的有用诊断标志物。然而,其结果应结合传统检查结果和患者的临床信息进行解读。