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积累 IP-10 在诊断肺结核中的证据。

Accumulate evidence for IP-10 in diagnosing pulmonary tuberculosis.

机构信息

Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, China.

出版信息

BMC Infect Dis. 2019 Oct 30;19(1):924. doi: 10.1186/s12879-019-4466-5.

Abstract

BACKGROUNDS

Pulmonary tuberculosis (PTB) is a major health and economic burden. Accurate PTB detection is an important step to eliminating TB globally. Interferon gamma-induced protein 10 (IP-10) has been reported as a potential diagnostic marker for PTB since 2007. In this study, a meta-analysis approach was used to assess diagnostic value of IP-10 for PTB.

METHODS

Web of Science, PubMed, the Cochrane Library, and Embase databases were searched for studies published in English up to February 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the area under the curve (AUC) and hierarchical summary receiver operating characteristic (HSROC) curve were estimated by the HSROC model and random effect model.

RESULTS

Eighteen studies including 2836 total participants met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of IP-10 for PTB detection were 86, 88%, 7.00, and 0.16, respectively. The pooled DOR was 43.01, indicating a very powerful discriminatory ability of IP-10. The AUC was 0.93 (95% CI: 0.91-0.95), showed the accuracy of IP-10 was good. Meta-regression showed that there was no heterogeneity with respect to TB burden, study design type, age, IP-10 assay method, IP-10 condition and HIV-infection status.

CONCLUSIONS

Our results showed that IP-10 is a promising marker for differentiating PTB from non-TB.

摘要

背景

肺结核(PTB)是一个主要的健康和经济负担。准确的肺结核检测是全球消除结核病的重要步骤。自 2007 年以来,干扰素γ诱导蛋白 10(IP-10)已被报道为肺结核的潜在诊断标志物。在这项研究中,采用荟萃分析方法评估了 IP-10 对肺结核的诊断价值。

方法

检索了 2019 年 2 月前发表的英文文献,包括 Web of Science、PubMed、Cochrane 图书馆和 Embase 数据库。采用 HSROC 模型和随机效应模型估计汇总敏感性、特异性、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)、曲线下面积(AUC)和分层汇总受试者工作特征(HSROC)曲线。

结果

共纳入 18 项研究,包括 2836 名患者。IP-10 检测肺结核的汇总敏感性、特异性、PLR 和 NLR 分别为 86%、88%、7.00 和 0.16。DOR 为 43.01,表明 IP-10 具有很强的鉴别能力。AUC 为 0.93(95%CI:0.91-0.95),表明 IP-10 的准确性较好。Meta 回归显示,TB 负担、研究设计类型、年龄、IP-10 检测方法、IP-10 条件和 HIV 感染状态与异质性无关。

结论

我们的结果表明,IP-10 是鉴别肺结核与非肺结核的有前途的标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bec/6822474/b8602a54a134/12879_2019_4466_Fig1_HTML.jpg

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