血清半乳甘露聚糖检测用于诊断儿科侵袭性曲霉菌病的Meta 分析。
Serum galactomannan for diagnosing invasive aspergillosis in pediatric patients: A meta-analysis.
机构信息
Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
Department of Clinical Laboratory, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.
出版信息
Microb Pathog. 2018 May;118:347-356. doi: 10.1016/j.micpath.2018.03.059. Epub 2018 Mar 31.
BACKGROUND
The serum galactomannan (GM) assay is used to diagnose invasive aspergillosis (IA). We conducted a systematic review and analysis to estimate the overall accuracy of the serum GM test for diagnosing pediatric IA.
METHOD
A systematic literature review was conducted of all relevant studies published in PubMed and EMbase databases up to March 10, 2017. We selected and assessed articles that reported diagnostic data related to serum GM for diagnosis of pediatric IA. Pooled diagnostic odds ratios (DORs) and summary receiver operating characteristics (SROCs) were constructed with a cutoff value of 0.5. Additionally, pooled sensitivity (SEN), specificity (SPE), and positive and negative likelihood ratios (PLR and NLR, respectively) were estimated for summarizing overall test performance.
RESULTS
Seventeen studies were included in this systematic review. The total number of patients (age range 0-21 years old) was 1768, with 178 that had proven or probable IA. The pooled serum GM assay results, with a cutoff value of 0.5 for proven or probable IA, were DOR: 41.16 (95% confidence interval (CI) 21.48-78.86), SEN: 0.85 (95% CI 0.72-0.93), SPE: 0.88 (95% CI 0.80-0.93), PLR: 6.92 (95% CI 4.40-10.88), and NLR: 0.17 (95% CI 0.09-0.32). The SROC was 0.93.
CONCLUSION
Serum GM can be used to assist in diagnosis of proven or probable pediatric IA. However, serum GM test results should be interpreted in combination with clinical findings in pediatric IA cases, as the test results are not always sensitive or specific enough for pediatric IA.
背景
血清半乳甘露聚糖（GM）检测被用于诊断侵袭性曲霉病（IA）。我们进行了系统综述和分析，以评估血清 GM 检测用于诊断儿科侵袭性曲霉病的总体准确性。
方法
对截止至 2017 年 3 月 10 日，在 PubMed 和 EMbase 数据库中发表的所有相关研究进行了系统文献检索。我们选择并评估了报告与用于诊断儿科侵袭性曲霉病的血清 GM 检测相关的诊断数据的文章。使用截止值为 0.5 构建了汇总诊断比值比（DOR）和汇总受试者工作特征曲线（SROC）。此外，还分别估计了汇总检测性能的汇总敏感性（SEN）、特异性（SPE）、阳性和阴性似然比（PLR 和 NLR）。
结果
本系统综述共纳入 17 项研究。患者总数（年龄范围 0-21 岁）为 1768 例，其中 178 例为确诊或疑似侵袭性曲霉病。使用截止值为 0.5 时，汇总血清 GM 检测结果为 DOR：41.16（95%置信区间（CI）为 21.48-78.86），SEN：0.85（95% CI 为 0.72-0.93），SPE：0.88（95% CI 为 0.80-0.93），PLR：6.92（95% CI 为 4.40-10.88），NLR：0.17（95% CI 为 0.09-0.32）。SROC 为 0.93。
结论
血清 GM 可用于辅助诊断确诊或疑似儿科侵袭性曲霉病。然而，应结合儿科侵袭性曲霉病病例的临床发现来解读血清 GM 检测结果，因为检测结果对于儿科侵袭性曲霉病并不总是足够敏感或特异。
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