Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Clinical Medicine, The First Clinical School of Guangzhou Medical University, Guangzhou, China.
J Clin Lab Anal. 2021 Jun;35(6):e23776. doi: 10.1002/jcla.23776. Epub 2021 Apr 1.
Nowadays, hand, foot, and mouth disease (HFMD) has a significant negative impact on children's health, especially in the Asia-Pacific region. Loop-mediated isothermal amplification assay (LAMP) is a highly efficient and convenient novel tool. However, its diagnostic accuracy for HFMD is still not clear. Therefore, we conducted a meta-analysis in order to evaluate the potential of LAMP assay for the diagnosis of HFMD, in which the reference standard was polymerase chain reaction (PCR).
A protocol was predetermined (CRD42020212882) in PROSPERO. We retrieved seven databases including PubMed for relevant studies published before October 2020. Articles were included if they compared the diagnostic efficiency of LAMP with PCR for HFMD through detecting clinical samples which was more than 15. Statistical analysis was performed by STATA 15.1 software. Risk of bias and applicability were assessed using Quality Assessment of Diagnostic Accuracy Studies. No funding was used for the study.
A total of 18 retrospective studies including 2495 samples from China were finally included. Reference standards of them included RT-PCR and non-RT-PCR. The merged sensitivity and specificity with 95% confidence interval (95% CI) were 1.00 (0.97-1.00) and 0.97 (0.88-0.99), respectively. The pooled PLR, NLR, and DOR with 95% CI were 11.17 (5.91-21.11), 0.05 (0.03-0.09), and 538.12 (183.17-1580.83), respectively. The AUC of SROC was 1.00 (95% CI: 0.99-1.00).
In conclusion, our research revealed high sensitivity and specificity of LAMP in diagnosing HFMD. However, more high-quality research is required to prove this conclusion.
如今,手足口病(HFMD)对儿童健康有重大负面影响,尤其是在亚太地区。环介导等温扩增检测法(LAMP)是一种高效、便捷的新型工具。然而,其用于诊断 HFMD 的准确性尚不清楚。因此,我们进行了一项荟萃分析,以评估 LAMP 检测法在诊断 HFMD 方面的潜力,其中参考标准为聚合酶链反应(PCR)。
在 PROSPERO 中预先制定了方案(CRD42020212882)。我们检索了包括 PubMed 在内的七个数据库,以获取截至 2020 年 10 月之前发表的相关研究。如果文章通过检测临床样本比较了 LAMP 与 PCR 对 HFMD 的诊断效率,且样本数大于 15,则将其纳入。统计分析采用 STATA 15.1 软件进行。采用诊断准确性研究质量评估工具(Quality Assessment of Diagnostic Accuracy Studies)评估偏倚风险和适用性。本研究未使用任何资金。
最终纳入了 18 项回顾性研究,共包含来自中国的 2495 个样本。其中,参考标准包括 RT-PCR 和非 RT-PCR。合并后的敏感度和特异度及其 95%置信区间(95% CI)分别为 1.00(0.97-1.00)和 0.97(0.88-0.99)。合并后的阳性似然比、阴性似然比和诊断比值比及其 95% CI 分别为 11.17(5.91-21.11)、0.05(0.03-0.09)和 538.12(183.17-1580.83)。SROC 的 AUC 为 1.00(95% CI:0.99-1.00)。
总之,我们的研究表明 LAMP 诊断 HFMD 的敏感度和特异度较高。然而,需要更多高质量的研究来证实这一结论。