Department of Neurology, Jiangxi Provincial People's Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, China.
Department of Neurology, Xiangya Hospital, Central South University, Jiangxi Hospital, National Regional Center for Neurological Diseases, Nanchang, Jiangxi, China.
Front Immunol. 2023 Sep 26;14:1223675. doi: 10.3389/fimmu.2023.1223675. eCollection 2023.
The utility of metagenomic next-generation sequencing (mNGS) in the diagnosis of tuberculous meningitis (TBM) remains uncertain. We performed a meta-analysis to comprehensively evaluate its diagnostic accuracy for the early diagnosis of TBM.
English (PubMed, Medline, Web of Science, Cochrane Library, and Embase) and Chinese (CNKI, Wanfang, and CBM) databases were searched for relevant studies assessing the diagnostic accuracy of mNGS for TBM. Review Manager was used to evaluate the quality of the included studies, and Stata was used to perform the statistical analysis.
Of 495 relevant articles retrieved, eight studies involving 693 participants (348 with and 345 without TBM) met the inclusion criteria and were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver-operating characteristic curve of mNGS for diagnosing TBM were 62% (95% confidence interval [CI]: 0.46-0.76), 99% (95% CI: 0.94-1.00), 139.08 (95% CI: 8.54-2266), 0.38 (95% CI: 0.25-0.58), 364.89 (95% CI: 18.39-7239), and 0.97 (95% CI: 0.95-0.98), respectively.
mNGS showed good specificity but moderate sensitivity; therefore, a more sensitive test should be developed to assist in the diagnosis of TBM.
宏基因组下一代测序（mNGS）在结核性脑膜炎（TBM）诊断中的应用尚不确定。我们进行了一项荟萃分析，以全面评估其在 TBM 早期诊断中的诊断准确性。
检索英文（PubMed、Medline、Web of Science、Cochrane Library 和 Embase）和中文（CNKI、万方和 CBM）数据库，评估 mNGS 对 TBM 诊断准确性的相关研究。使用 Review Manager 评估纳入研究的质量，使用 Stata 进行统计分析。
在 495 篇相关文章中，有 8 项研究纳入了 693 名参与者（348 名 TBM 患者和 345 名非 TBM 患者），符合纳入标准并纳入荟萃分析。mNGS 诊断 TBM 的汇总敏感性、特异性、阳性似然比、阴性似然比、诊断优势比和汇总受试者工作特征曲线下面积分别为 62%（95%可信区间：0.46-0.76）、99%（95%可信区间：0.94-1.00）、139.08（95%可信区间：8.54-2266）、0.38（95%可信区间：0.25-0.58）、364.89（95%可信区间：18.39-7239）和 0.97（95%可信区间：0.95-0.98）。
mNGS 显示出良好的特异性和中等的敏感性；因此，应开发更敏感的检测方法来辅助 TBM 的诊断。
