Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China.
Department of Tuberculosis, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China.
PLoS One. 2018 Jun 26;13(6):e0199290. doi: 10.1371/journal.pone.0199290. eCollection 2018.
Loop-mediated isothermal amplification (LAMP) is used to detect pulmonary tuberculosis (PTB); however, the diagnostic accuracy of the LAMP assay for extrapulmonary tuberculosis (EPTB) is unclear. We performed a meta-analysis to evaluate the performance of LAMP in the detection of EPTB.
We searched PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and the Wanfang database for studies published before Sep 16, 2017. We reviewed studies and compared the performance of LAMP with that of a composite reference standard (CRS) and culture for clinically suspected EPTB. We used a bivariate random-effects model to perform meta-analyses and used meta-regression and subgroup analysis to analyze sources of heterogeneity.
Fourteen articles including 24 independent studies (16 compared LAMP to CRS, 8 to culture) of EPTB were identified. LAMP showed a pooled sensitivity of 77% (95% confidence interval (CI) 68-85), specificity of 99% (95% CI 96-100), and area under SROC curves (AUC) of 0.96 (95% CI 0.94-0.97) against CRS. It showed a pooled sensitivity of 93% (95% CI 88-96), specificity of 77% (95% CI 64-86), and AUC of 0.94 (95% CI 0.92-0.96) against culture. The pooled sensitivity, specificity, and AUC of MPB64 LAMP were 86% (95% CI 86-86), 100% (95% CI 100-100), and 0.97 (95% CI 0.95-0.98), respectively, and those of IS6110 LAMP were 75% (95% CI 64-84), 99% (95% CI 90-100), and 0.91 (95% CI 0.88-0.93), respectively, compared with CRS.
These results suggest good diagnostic efficacy of LAMP in the detection of EPTB. Additionally, the diagnostic efficacy of MPB64 LAMP was superior to that of IS6110 LAMP.
环介导等温扩增（LAMP）用于检测肺结核（PTB）；然而，LAMP 检测对肺外结核（EPTB）的诊断准确性尚不清楚。我们进行了一项荟萃分析，以评估 LAMP 在检测 EPTB 中的性能。
我们检索了 PubMed、EMBASE、Cochrane 图书馆、中国知网（CNKI）和万方数据库，检索时间截至 2017 年 9 月 16 日。我们对研究进行了回顾，并比较了 LAMP 与复合参考标准（CRS）和培养物对临床疑似 EPTB 的检测性能。我们使用双变量随机效应模型进行荟萃分析，并使用Meta 回归和亚组分析来分析异质性的来源。
确定了 14 篇文章，其中包括 24 项关于 EPTB 的独立研究（16 项比较 LAMP 与 CRS，8 项比较 LAMP 与培养物）。LAMP 对 CRS 的汇总敏感性为 77%（95%置信区间[CI] 68-85），特异性为 99%（95%CI 96-100），SROC 曲线下面积（AUC）为 0.96（95%CI 0.94-0.97）。LAMP 对培养物的汇总敏感性为 93%（95%CI 88-96），特异性为 77%（95%CI 64-86），AUC 为 0.94（95%CI 0.92-0.96）。MPB64 LAMP 的汇总敏感性、特异性和 AUC 分别为 86%（95%CI 86-86）、100%（95%CI 100-100）和 0.97（95%CI 0.95-0.98），IS6110 LAMP 分别为 75%（95%CI 64-84）、99%（95%CI 90-100）和 0.91（95%CI 0.88-0.93）。
这些结果表明 LAMP 在检测 EPTB 方面具有良好的诊断效果。此外，MPB64 LAMP 的诊断效果优于 IS6110 LAMP。
