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Xpert MTB/RIF 检测胃抽吸物中结核分枝杆菌的临床诊断价值。

The clinical diagnostic value of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in gastric aspirates.

机构信息

Department of Clinical Medicine, the Third Clinical School of Guangzhou Medical University, Guangzhou 511436, China.

Department of Clinical Laboratory Medicine, the Third affiliated hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Biosci Rep. 2020 Jun 26;40(6). doi: 10.1042/BSR20200138.

DOI:10.1042/BSR20200138

PMID:32543657

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7313445/

Abstract

BACKGROUND

At present, the infection and prevalence rates of tuberculosis (TB) are still high in worldwide. The Xpert MTB/RIF technology has improved the diagnosis speed of Mycobacterium tuberculosis (MTB) and facilitated the rapid treatment of TB patients.

METHODS

We searched experimental data derived from Xpert MTB/RIF for detecting MTB in gastric aspirates in PubMed, Embase, Web Of Science, and the Cochrane Library databases between January 2012 to April 2019. A summary receiver operating characteristic curve (SROC curve) was used to analyze the pooled sensitivity, pooled specificity, PLR, NLR, and DOR for determining the accuracy of the test.

RESULTS

Our database search resulted in 10 relevant articles. The pooled sensitivity of Xpert MTB/RIF for detecting TB in GA was 86% (95% CI, 83-89%), and I2 = 93.4%. The pooled specificity was 92% (95% CI, 90-93%) and I2 = 97.8%. In addition, the positive LR was 12.12 (95% CI, 5.60-26.21), negative LR was 0.20 (95% CI, 0.11-0.36), and the diagnostic odds ratio (DOR) was 147.04 (95% CI, 37.20-581.19). Using the SROC curve, the AUC was 0.9730 and Q* was 0.9248 (SE = 0.0261). The publication bias was P=0.517 (P>0.05).

CONCLUSIONS

The Xpert MTB/RIF for detecting MTB in gastric aspirates was highly accurate. In addition, we observed that the publication bias in the present study was low. Hence, the Xpert MTB/RIF technology is highly accurate and has the advantage of rapid testing for MTB in clinical samples.

摘要

背景

目前，结核病（TB）的感染率和流行率在全球范围内仍然很高。Xpert MTB/RIF 技术提高了分枝杆菌（MTB）的诊断速度，有助于快速治疗 TB 患者。

方法

我们在 PubMed、Embase、Web Of Science 和 Cochrane Library 数据库中检索了 2012 年 1 月至 2019 年 4 月期间关于 Xpert MTB/RIF 检测胃抽吸物中 MTB 的实验数据。使用汇总受试者工作特征曲线（SROC 曲线）分析检测试验的准确性的汇总敏感性、汇总特异性、阳性似然比、阴性似然比和诊断比值比（DOR）。

结果

我们的数据库检索结果有 10 篇相关文章。Xpert MTB/RIF 检测 GA 中 TB 的汇总敏感性为 86%（95%CI，83-89%），I2=93.4%。汇总特异性为 92%（95%CI，90-93%），I2=97.8%。此外，阳性似然比为 12.12（95%CI，5.60-26.21），阴性似然比为 0.20（95%CI，0.11-0.36），诊断比值比（DOR）为 147.04（95%CI，37.20-581.19）。使用 SROC 曲线，AUC 为 0.9730，Q*为 0.9248（SE=0.0261）。发表偏倚 P=0.517（P>0.05）。