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血清1,3-β-D-葡聚糖对侵袭性真菌感染的诊断效能:基于37项病例或队列研究的最新Meta分析

Diagnostic Efficacy of Serum 1,3-β-D-glucan for Invasive Fungal Infection: An Update Meta-Analysis Based on 37 Case Or Cohort Studies.

作者信息

Xiaoling Lu, Tingyu Tang, Caibao Hu, Tian Zhao, Changqin Chen

机构信息

Department of Respiratory, Zhejiang Hospital, Hangzhou, China, 310013.

Department of ICU, Zhejiang Hospital, Hangzhou, China, 310013.

出版信息

Open Med (Wars). 2018 Sep 8;13:329-337. doi: 10.1515/med-2018-0050. eCollection 2018.

Abstract

OBJECTIVE

The aim of this study was to investigate the diagnostic performance of serum 1,3-β-D-gluan as biomarker for invasive fungal infection through meta-analysis.

METHODS

The electronic databases of Medline, Cochrane, Embase, Web of Science, OVID and CNKI were systematic searched to identified the case-control or Cohort studies relevant to diagnostic efficacy of serum 1,3-β-D-glucan for invasive fungal infection. The data of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) patients number were extracted from each of the original included studies. The diagnostic sensitivity, specificity and systematic receiver operating characteristic (SROC) curve were calculated and pooled through random or fixed effect method. The publication bias was evaluated by the Deek's funnel plot.

RESULTS

Thirty-seven relevant studies were fulfilled the inclusion criteria and included in our present meta-analysis. The combined sensitivity, specificity, positive likely hood ratio (+lr), negative likely hood ratio (-lr) and diagnostic odds ratio(dor) for 1,3-β-D-glucan in diagnosis of invasive fungal infectionwere 0.83 (95%CI:0.38-0.61), 0.81 (95%CI:0.80-0.82), 5.13 (95%CI:3.98-6.62), 0.23 (95%CI:0.18-0.30), and 29.68 (95%CI:18.94-46.52) respectively. The pooled area under the ROC curve (AUC) was 0.91.The Deek's funnel plot asymmetry test showed there was no publication bias for 1,3-β-D-glucan in diagnosis of invasive fungal infection of the included 37 studies.

CONCLUSION

Serum 1,3-β-D-glucan assay was a promising biomarker for invasive fungal infection diagnosis.

摘要

目的

本研究旨在通过荟萃分析探讨血清1,3-β-D-葡聚糖作为侵袭性真菌感染生物标志物的诊断效能。

方法

系统检索Medline、Cochrane、Embase、Web of Science、OVID和CNKI等电子数据库,以识别与血清1,3-β-D-葡聚糖对侵袭性真菌感染诊断效能相关的病例对照或队列研究。从每项纳入的原始研究中提取真阳性(tp)、假阳性(fp)、假阴性(fn)和真阴性(tn)患者数量的数据。通过随机或固定效应方法计算并汇总诊断敏感性、特异性和系统受试者工作特征(SROC)曲线。采用Deek漏斗图评估发表偏倚。

结果

37项相关研究符合纳入标准并纳入本荟萃分析。1,3-β-D-葡聚糖诊断侵袭性真菌感染的合并敏感性、特异性、阳性似然比(+lr)、阴性似然比(-lr)和诊断比值比(dor)分别为0.83(95%CI:0.38 - 0.61)、0.81(95%CI:0.80 - 0.82)、5.13(95%CI:3.98 - 6.62)、0.23(95%CI:0.18 - 0.30)和29.68(95%CI:18.94 - 46.52)。ROC曲线下的合并面积(AUC)为0.91。Deek漏斗图不对称性检验显示,纳入的37项研究中,1,3-β-D-葡聚糖诊断侵袭性真菌感染不存在发表偏倚。

结论

血清1,3-β-D-葡聚糖检测是一种有前景的侵袭性真菌感染诊断生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6e/6132083/796e52994c9f/med-13-329-g001.jpg

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