Wang Yan, He Yu, Wang Li, Zhang Yan-An, Wang Mao-Shui
Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China.
Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Open Forum Infect Dis. 2023 Feb 14;10(3):ofad082. doi: 10.1093/ofid/ofad082. eCollection 2023 Mar.
The diagnostic accuracy of oral specimen nucleic acid amplification tests (NAATs) for pulmonary tuberculosis (PTB) remains controversial. We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies that reported the diagnostic yield of NAATs in oral samples for PTB diagnosis. The pooled estimates, including those of sensitivity and specificity, were calculated, and a meta-regression was performed to investigate heterogeneity, which was determined using χ and ² tests. A total of 23 articles were included, and the pooled sensitivity, specificity, and area under the curve of NAATs in oral samples for PTB diagnosis were 50% (95% CI, 37%-63%), 97% (95% CI, 93%-99%), and 0.89 (95% CI, 86%-92%; = 99%; chi-square, 169.61; < .001), respectively. Our data demonstrated that NAATs using oral samples have a less satisfactory sensitivity and high specificity for PTB diagnosis. However, due to significant heterogeneity, such as heterogeneity in age, the results should be interpreted with caution.
口腔标本核酸扩增试验（NAATs）用于肺结核（PTB）诊断的准确性仍存在争议。我们根据系统评价和Meta分析的首选报告项目指南进行了一项系统评价，纳入了报告NAATs在口腔样本中对PTB诊断的诊断率的研究。计算了合并估计值，包括敏感性和特异性，并进行了Meta回归以研究异质性，异质性通过χ²检验确定。共纳入23篇文章，NAATs在口腔样本中对PTB诊断的合并敏感性、特异性和曲线下面积分别为50%（95%CI，37%-63%）、97%（95%CI，93%-99%）和0.89（95%CI，86%-92%；I² = 99%；卡方，169.61；P <.001）。我们的数据表明，使用口腔样本的NAATs对PTB诊断的敏感性不太令人满意，但特异性较高。然而，由于存在显著的异质性，如年龄异质性，结果应谨慎解释。
