Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China.
Engineering Research Center of Bone and Joint Precision Medicine, Peking University Third Hospital, Haidian, Beijing, China.
Knee Surg Sports Traumatol Arthrosc. 2024 Sep;32(9):2277-2289. doi: 10.1002/ksa.12227. Epub 2024 May 7.
The next-generation sequencing (NGS) has developed rapidly in the past decade and is becoming a promising diagnostic tool for periprosthetic infection (PJI). However, its diagnostic value for PJI is still uncertain. The purpose of this systematic review and meta-analysis was to evaluate the diagnostic value of NGS compared to culture.
In this systematic review and meta-analysis, electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and clinicaltrials.gov were searched for studies from inception to 12 November 2023. Diagnostic parameters, such as sensitivity, specificity, diagnostic odds ratio and area under the summary receiver-operating characteristic (SROC) curve (AUC), were calculated for the included studies. A systematic review and meta-analysis was performed.
A total of 22 studies with 2461 patients were included in our study. The pooled sensitivity, specificity and diagnostic odds ratio of NGS were 87% (95% confidence interval [CI]: 83-90), 94% (95% CI: 91-96) and 111 (95% CI: 70-177), respectively. On the other hand, the pooled sensitivity, specificity and diagnostic odds ratio of culture were 63% (95% CI: 58-67), 98% (95% CI: 96-99) and 93 (95% CI: 40-212), respectively. The SROC curve for NGS and culture showed that the AUCs are 0.96 (95% CI: 0.94-0.98) and 0.82 (95% CI: 0.79-0.86), respectively.
This systematic review and meta-analysis found NGS had higher sensitivity and diagnostic accuracy but slightly lower specificity than culture. Based on the pooled results, we suggested NGS may have the potential to be a new tool for the diagnosis of PJI.
Level IV.
下一代测序（NGS）在过去十年中发展迅速，正在成为一种有前途的假体周围感染（PJI）诊断工具。然而，其对 PJI 的诊断价值仍不确定。本系统评价和荟萃分析的目的是评估 NGS 与培养相比的诊断价值。
在本系统评价和荟萃分析中，从成立到 2023 年 11 月 12 日，我们检索了电子数据库，包括 PubMed、Embase、Cochrane 对照试验中心注册库、Web of Science 和 clinicaltrials.gov，以查找研究。为纳入的研究计算了诊断参数，如敏感性、特异性、诊断优势比和汇总受试者工作特征（SROC）曲线下面积（AUC）。进行了系统评价和荟萃分析。
我们的研究共纳入了 22 项研究，共 2461 名患者。NGS 的汇总敏感性、特异性和诊断优势比分别为 87%（95%置信区间[CI]：83-90）、94%（95% CI：91-96）和 111（95% CI：70-177）。另一方面，培养的汇总敏感性、特异性和诊断优势比分别为 63%（95% CI：58-67）、98%（95% CI：96-99）和 93（95% CI：40-212）。NGS 和培养的 SROC 曲线表明 AUC 分别为 0.96（95% CI：0.94-0.98）和 0.82（95% CI：0.79-0.86）。
本系统评价和荟萃分析发现，NGS 的敏感性和诊断准确性较高，但特异性略低于培养。基于汇总结果，我们建议 NGS 可能有潜力成为 PJI 诊断的新工具。
IV 级。
