Ing Edsel B, Wang Dan Ni, Kirubarajan Abirami, Benard-Seguin Etienne, Ma Jingyi, Farmer James P, Belliveau Michel J, Sholohov Galina, Torun Nurhan
University of Toronto Ophthalmology, Michael Garron Hospital, University of Toronto, Toronto, Canada.
Cumming School of Medicine, University of Calgary, Calgary, Canada.
Neuroophthalmology. 2018 Jun 19;43(1):18-25. doi: 10.1080/01658107.2018.1474372. eCollection 2019 Feb.
To determine the positive yield (utility rate) of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).
Systematic review (CRD42017078508) and meta-regression.
All articles concerning TAB for suspected GCA with English language abstracts from 1998 to 2017 were retrieved. Articles were excluded if they exclusively reported positive TAB, or only cases of known GCA. Where available, the pre-specified predictors of age, sex, vision symptoms, jaw claudication, duration of steroid treatment prior to TAB, specimen length, bilateral TAB, and use of ultrasound/MRI (imaging) were recorded for meta-regression.
One hundred and thirteen articles met eligibility criteria. The was 92%, and with such high heterogeneity, meta-analysis is unsuitable. The median yield of TAB was 0.25 (95% confidence interval 0.21 to 0.27), with interquartile range 0.17 to 0.34. On univariate meta-regression age (coefficient 0.012, = 0.025) was the only statistically significant patient factor associated with TAB yield.
Systematic review revealed high heterogeneity in the yield of TAB. The median utility rate of 25% and its interquartile range provides a benchmark for decisions regarding the under/overutilization of TAB and aids in the evaluation of non-invasive alternatives for the investigation of GCA.
确定颞动脉活检（TAB）在疑似巨细胞动脉炎（GCA）患者中的阳性检出率（实用率）。
系统评价（CRD42017078508）和Meta回归分析。
检索1998年至2017年所有关于疑似GCA的TAB且有英文摘要的文章。如果文章仅报道了TAB阳性结果，或仅报道了已知GCA的病例，则将其排除。如有可用数据，记录年龄、性别、视力症状、颌部跛行、TAB前类固醇治疗持续时间、标本长度、双侧TAB以及超声/MRI（影像学）使用情况等预先设定的预测因素，用于Meta回归分析。
113篇文章符合纳入标准。 为92%，异质性如此之高，不适合进行Meta分析。TAB的中位检出率为0.25（95%置信区间0.21至0.27），四分位间距为0.17至0.34。单变量Meta回归分析显示，年龄（系数0.012， = 0.025）是与TAB检出率相关的唯一具有统计学意义的患者因素。
系统评价显示TAB检出率存在高度异质性。25%的中位实用率及其四分位间距为判断TAB使用不足/过度使用提供了基准，并有助于评估用于GCA检查的非侵入性替代方法。
