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血清可溶性白细胞介素-2受体水平在结节病诊断中的作用：一项系统评价和荟萃分析

Role of Serum Soluble Interleukin-2 Receptor Level in the Diagnosis of Sarcoidosis: A Systematic Review and Meta-Analysis.

作者信息

Gupta Samiksha, Padappayil Rana Prathap, Bansal Agam, Daouk Salim

机构信息

Department of Pulmonary and Critical Care Medicine Case Western Reserve University, Cleveland, Ohio .

Department of Internal Medicine University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2023 Mar 28;40(1):e2023005. doi: 10.36141/svdld.v40i1.13499.

DOI:10.36141/svdld.v40i1.13499
PMID:36975055
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10099658/
Abstract

BACKGROUND AND AIM

Serum Soluble Interleukin-2 Receptor (sIL-2R) levels are used clinically as a disease activity marker for systemic sarcoidosis. Studies have investigated the diagnostic role of serum soluble interleukin-2 receptor (sIL-2R) level for sarcoidosis relative to biopsy. We performed a systematic review and meta-analysis of studies evaluating the diagnostic utility of sIL-2R.

METHODS

We carried out an electronic search in Medline, Embase, Google Scholar, and Cochrane databases using keyword and Medical Subject Heading (MeSH) terms: sarcoidosis and sIL-2R. Studies evaluating the sIL-2R levels as a diagnostic tool in clinically diagnosed or biopsy-proven sarcoidosis patients compared to control groups with non-sarcoidosis patients were included. Forest plots were constructed using a random effect model depicting pooled sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy.

RESULTS

We selected ten studies comprising 1477 patients, with 592 in the sarcoidosis group and 885 in the non- sarcoidosis group. Pooled sensitivity and specificity of sIL-2R levels were 0.88 (95% CI: 0.75-0.95) and 0.87 (95% CI 0.73-0.94) respectively. Pooled negative predictive value and positive predictive value were 0.91 (95% CI 0.77-0.97) and 0.85 (95% CI 0.59-0.96) respectively with diagnostic accuracy of 0.86 (95% CI 0.71- 0.93).

CONCLUSION

In addition to its utility as a marker of sarcoidosis disease activity, sIL-2R has high diagnostic accuracy. Despite the limitations of the heterogenous sarcoidosis population and different sIL-2R cutoffs, our results suggest that sIL-2R is an important biomarker that can be used to confirm sarcoidosis diagnosis in unconfirmed or unclear cases.

摘要

背景与目的

血清可溶性白细胞介素-2受体（sIL-2R）水平在临床上被用作系统性结节病的疾病活动标志物。已有研究探讨了血清可溶性白细胞介素-2受体（sIL-2R）水平相对于活检在结节病诊断中的作用。我们对评估sIL-2R诊断效用的研究进行了系统评价和荟萃分析。

方法

我们在Medline、Embase、谷歌学术和Cochrane数据库中进行了电子检索，使用关键词和医学主题词（MeSH）：结节病和sIL-2R。纳入了评估sIL-2R水平作为临床诊断或经活检证实的结节病患者诊断工具，并与非结节病患者对照组进行比较的研究。使用随机效应模型构建森林图，描绘合并敏感性、特异性、阳性和阴性预测值以及诊断准确性。

结果

我们选择了10项研究，共1477例患者，其中结节病组592例，非结节病组885例。sIL-2R水平的合并敏感性和特异性分别为0.88（95%CI：0.75-0.95）和0.87（95%CI 0.73-0.94）。合并阴性预测值和阳性预测值分别为0.91（95%CI 0.77-0.97）和0.85（95%CI 0.59-0.96），诊断准确性为0.86（95%CI 0.71-0.93）。

结论

除了作为结节病疾病活动的标志物外，sIL-2R具有较高的诊断准确性。尽管结节病人群异质性和不同的sIL-2R临界值存在局限性，但我们的结果表明，sIL-2R是一种重要的生物标志物，可用于在未确诊或不明确的病例中确诊结节病。

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