血液病恶性肿瘤或实体瘤患者β-d-葡聚糖（Fungitell）检测的诊断准确性：系统评价和荟萃分析。
Diagnostic Accuracy of β-d-Glucan (Fungitell) Testing Among Patients With Hematologic Malignancies or Solid Organ Tumors: A Systematic Review and Meta-Analysis.
机构信息
Department of Pathology, Division of Infectious Disease, Health Sciences Center, University of Utah, Salt Lake City.
Associated Regional and University Pathologists Laboratories, Salt Lake City, UT.
出版信息
Am J Clin Pathol. 2019 Feb 4;151(3):275-285. doi: 10.1093/ajcp/aqy135.
OBJECTIVES
To determine the accuracy of Fungitell, a β-d-glucan (BDG) test, for the diagnosis of invasive fungal infection (IFI) among cancer patients.
METHODS
For this meta-analysis, MEDLINE and EMBASE were searched for references related to BDG testing. Study quality was evaluated using QUADAS-2. Statistical analysis was performed using Stata 14.
RESULTS
We screened 12,426 references and identified 189 studies for full-text review. Nineteen studies were included in the final meta-analysis. There was moderate heterogeneity between studies. Nine studies had a high risk of bias, which significantly elevated the overall specificity estimate. Restricting to only low-bias studies, the sensitivity and specificity were 80% and 63%, respectively.
CONCLUSIONS
The overall sensitivity and specificity of Fungitell as a diagnostic test for IFI is moderate, and there is substantial heterogeneity between studies. Limiting studies to only low-bias risk reduced heterogeneity but also lowered the overall specificity estimate.
目的
评估 Fungitell（一种β-D-葡聚糖（BDG）检测）对癌症患者侵袭性真菌感染（IFI）的诊断准确性。
方法
本荟萃分析检索了 MEDLINE 和 EMBASE 中与 BDG 检测相关的参考文献。使用 QUADAS-2 评估研究质量。使用 Stata 14 进行统计分析。
结果
我们筛选了 12426 篇参考文献，并对 189 篇进行了全文审查。19 项研究纳入最终荟萃分析。研究间存在中度异质性。9 项研究存在高偏倚风险，这显著提高了总体特异性估计值。仅限制低偏倚研究，敏感性和特异性分别为 80%和 63%。
结论
Fungitell 作为 IFI 诊断检测的总体敏感性和特异性为中等，研究间存在显著异质性。仅限制低偏倚风险的研究降低了异质性，但也降低了总体特异性估计值。
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