结核的分子标志物及其临床相关性：系统评价和荟萃分析。

Molecular markers of tuberculosis and their clinical relevance: a systematic review and meta-analysis.

机构信息

Department of Clinical Laboratory, Affiliated Nantong Hospital of Shanghai University, Nantong, China; Department of Pathogen Biology, School of Medicine, Nantong University, Nantong, China.

Department of Pathogen Biology, School of Medicine, Nantong University, Nantong, China; Department of Clinical Laboratory, Disease Control and Prevention Center of Rugao, Nantong, China.

出版信息

Ann Palliat Med. 2022 Feb;11(2):532-543. doi: 10.21037/apm-21-3739.

DOI:10.21037/apm-21-3739

PMID:35249331

Abstract

BACKGROUND

Since research on disease biomarkers of tuberculosis (TB) and latent tuberculosis infection (LTBI) provides hope for simple point-of-care testing, we aim to summarize and analyze the evidence for the clinical relevance of IFN-γ-inducible protein 10 (IP-10) and IFN-γ/interleukin 2 (IL-2) as diagnostic biomarkers for TB.

METHODS

The search terms tuberculosis, tuberculous pleurisy, pulmonary tuberculosis, latent tuberculosis infection, biomarkers, markers, IFN-γ-inducible protein 10, IP-10, interleukin 2, and IL-2 were used to search the PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases. The retrieval time was from the establishment of the database to September 2021. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and the meta-analysis was performed using RevMan 5.20.

RESULTS

A total of 9 articles were included for meta-analysis. The quality assessment showed that the overall quality of the included articles was met the requirements. The results showed that the overall sensitivity and specificity of IP-10 were 0.77 (95% CI, 0.71-0.82) and 0.84 (95% CI, 0.80-0.88), respectively. The overall sensitivity and specificity of IL-2 were 0.82 (95% CI, 0.74-0.89) and 0.95 (95% CI, 0.88-0.98), respectively. The areas under the curves (AUCs) of the IP-10 and IL-2 summary receiver operating characteristic (SROC) curves were 0.8592 and 0.9666, respectively.

DISCUSSION

The results of this systematic review and meta-analysis showed that IP-10 and IL-2 as biomarkers have good clinical relevance to TB and can be used for the clinical screening of high-risk TB populations. However, a prospective cohort study across multiple regions using a large sample size should also be conducted.

摘要

背景

由于针对结核病（TB）和潜伏性结核感染（LTBI）的疾病生物标志物的研究为简单的即时护理检测提供了希望，因此我们旨在总结和分析 IFN-γ 诱导蛋白 10（IP-10）和 IFN-γ/白细胞介素 2（IL-2）作为 TB 诊断生物标志物的临床相关性的证据。

方法

使用“tuberculosis、tuberculous pleurisy、pulmonary tuberculosis、latent tuberculosis infection、biomarkers、markers、IFN-γ-inducible protein 10、IP-10、interleukin 2、IL-2”等检索词，检索 PubMed、Cochrane 中央对照试验注册库、EMBASE、Web of Science、中国知网（CNKI）、万方和维普数据库，检索时间为数据库建立至 2021 年 9 月。使用 Cochrane 偏倚风险工具评估纳入研究的质量，并使用 RevMan 5.20 进行荟萃分析。

结果

共纳入 9 篇文章进行荟萃分析。质量评估显示，纳入研究的整体质量符合要求。结果显示，IP-10 的总体敏感性和特异性分别为 0.77（95%CI，0.71-0.82）和 0.84（95%CI，0.80-0.88）。IL-2 的总体敏感性和特异性分别为 0.82（95%CI，0.74-0.89）和 0.95（95%CI，0.88-0.98）。IP-10 和 IL-2 汇总受试者工作特征（SROC）曲线的曲线下面积（AUC）分别为 0.8592 和 0.9666。