肾移植中采用酶联免疫斑点法（ELISPOT）和巨细胞病毒定量干扰素检测法（QuantiFERON-CMV）进行巨细胞病毒（CMV）免疫监测的诊断性能：一篇遵循系统评价和Meta分析的首选报告项目（PRISMA）规范的文章。

Diagnostic performance of cytomegalovirus (CMV) immune monitoring with ELISPOT and QuantiFERON-CMV assay in kidney transplantation: A PRISMA-compliant article.

作者信息

Ruan Yashi, Guo Wei, Liang Sudong, Xu Zhen, Niu Tianli

机构信息

Department of Urology, Taizhou People's Hospital, Jiangsu, China.

出版信息

Medicine (Baltimore). 2019 Apr;98(16):e15228. doi: 10.1097/MD.0000000000015228.

DOI:10.1097/MD.0000000000015228

PMID:31008952

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6494277/

Abstract

BACKGROUND

Cytomegalovirus (CMV) infection is part of major infection complications following kidney transplantation. However, more rapid and low-complexity assays are needed for CMV infection. Our study is to investigate the diagnostic efficacy of 2 novel tests, CMV-ELISPOT and QuantiFERON-CMV tests, in CMV DNA viremia and CMV infection following renal transplant.

METHODS

We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science. Case-control or cohort study designed to explore the CMV-ELISPOT and/or QuantiFERON-CMV tests in the recipients with CMV infection was considered to be eligible for this study. Sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curves were calculated.

RESULTS

We selected a total of 12 articles for systematic review and 11 of them were included in meta-analysis. For CMV-pp65 assay, the pooled SEN, SPE, and DOR were 0.73 (95% confidence interval [CI], 0.67-0.78), 0.61 (95% CI, 0.56-0.65), and 4.46 (95% CI, 3.11-6.39), respectively. For CMV-IE-1 assay, the pooled SEN, SPE, and DOR were 0.84 (95% CI, 0.78-0.88), 0.46 (95% CI, 0.42-0.51), and 5.07 (95% CI, 3.26-7.89), respectively, whereas the pooled SEN, SPE, and DOR of QuantiFERON-CMV test were 0.38 (95% CI, 0.28-0.49), 0.38 (95% CI, 0.32-0.44), and 1.02 (95% CI, 0.17-6.00).

CONCLUSIONS

We reported that CMV-ELISPOT tests, including CMV-pp65 and CMV-IE-1, perform well in the diagnosis and prediction of CMV infection in renal transplant recipients, whereas QuantiFERON-CMV test needs further exploration.

摘要

背景

巨细胞病毒（CMV）感染是肾移植后主要感染并发症的一部分。然而，对于CMV感染需要更快速且低复杂度的检测方法。我们的研究旨在探讨两种新型检测方法，即CMV-ELISPOT和QuantiFERON-CMV检测法，在肾移植后CMV DNA病毒血症和CMV感染中的诊断效能。

方法

我们检索了MEDLINE、EMBASE、Cochrane对照试验中心注册库和科学引文索引。旨在探索CMV-ELISPOT和/或QuantiFERON-CMV检测法在CMV感染受者中的病例对照或队列研究被认为符合本研究的纳入标准。计算敏感性（SEN）、特异性（SPE）、诊断比值比（DOR）和汇总受试者工作特征（SROC）曲线。

结果

我们共筛选出12篇文章进行系统评价，其中11篇纳入荟萃分析。对于CMV-pp65检测，汇总的SEN、SPE和DOR分别为0.73（95%置信区间[CI]，0.67 - 0.78）、0.61（95%CI，0.56 - 0.65）和4.46（95%CI，3.11 - 6.39）。对于CMV-IE-1检测，汇总的SEN、SPE和DOR分别为0.84（95%CI，0.78 - 0.88）、0.46（95%CI，0.42 - 0.51）和5.07（95%CI，3.26 - 7.89），而QuantiFERON-CMV检测的汇总SEN、SPE和DOR分别为0.38（95%CI，0.28 - 0.49）、0.38（95%CI，0.32 - 0.44）和1.02（95%CI，0.17 - 6.00）。