干扰素γ释放试验在骨关节结核诊断中的应用：系统评价和荟萃分析。

Interferon gamma release assays for diagnosis of osteoarticular tuberculosis: A systematic review and meta-analysis.

机构信息

Department of Cardiothoracic Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Department of Biostatistics and Epidemiology, School of Public Health, Shenyang Medical College, Shenyang, China.

出版信息

PLoS One. 2022 Jun 30;17(6):e0269234. doi: 10.1371/journal.pone.0269234. eCollection 2022.

BACKGROUND

Although the Interferon Gamma Release Assays (IGRA) is often used to identify latent tuberculosis, it also plays a crucial role in diagnosing active extrapulmonary tuberculosis. Some studies have assessed the use of IGRA as a biomarker for osteoarticular tuberculosis (OATB), which is elevated following TB infection. Still, conclusive results about its effectiveness have not been reported.

METHOD

We searched PubMed, Embase, and Cochran databases. We obtained literature related to the diagnosis of OATB by IGRA, and the retrieval period was from the establishment of the database to June 2021. The bivariate random effect model was used to summarize the sensitivity, specificity, and accuracy of other indicators in diagnosing OATB by IGRA, and the forest plot and receiver operating characteristic (ROC) curve were used for testing.

RESULTS

We included seven studies involving 643 subjects in diagnosing OATB by IGRA. The comprehensive sensitivity and specificity were 0.84 (95% CI, 0.70-0.92) and 0.78 (95% CI, 0.66-0.87), respectively. The area under the curve (AUC) was 0.87.

CONCLUSION

In blood samples, the diagnostic accuracy of IGRAS is poor in patients with suspected OAT. We conclude that IGRA may not be appropriate for patients with OATB.

背景

干扰素释放试验（IGRA）常用于检测潜伏性结核，但在诊断肺外活动性结核方面也起着至关重要的作用。一些研究评估了 IGRA 作为骨关节结核（OATB）生物标志物的作用，在结核感染后其水平升高。然而，其有效性的结论性结果尚未报道。

方法

我们检索了 PubMed、Embase 和 Cochrane 数据库。检索了有关 IGRA 诊断 OATB 的文献，检索时间从数据库建立到 2021 年 6 月。使用双变量随机效应模型汇总 IGRA 诊断 OATB 的其他指标的敏感性、特异性和准确性，并用森林图和受试者工作特征（ROC）曲线进行检验。