γ干扰素诱导蛋白10对活动性结核和潜伏性结核感染的鉴别诊断价值的系统评价和meta分析

Diagnostic accuracy of interferon gamma-induced protein 10 for differentiating active tuberculosis from latent tuberculosis:a systematic review and meta-analysis

目的系统评价γ干扰素诱导蛋白10(IP-10)对活动性结核和潜伏性结核感染的鉴别诊断价值。方法检索PubMed、EMBASE、Cochrane图书馆和Web of science数据库,检索时间截止2019年3月,纳入英文发表IP-10对活动性结核和潜伏性结核感染的鉴别诊断试验研究,2名研究人员进行数据提取和质量评价后,采用stata14.0软件进行统计分析。结果共纳入10篇文献,14个研究共773例患者,Meta分析结果显示合并敏感度、合并特异度、合并阳性似然比、阴性似然比、诊断比值比和ROC曲线下面积依次0.80(95%CI:0.71~0.87)、0.90(95%CI:0.81~0.95)、7.97(95%CI:4.07~15.61)、0.22(95%CI:0.15~0.33)、35.97(95%CI:14.93~86.65)和0.91(95%CI:0.88~0.93)。Deek′s漏斗图提示存在发表偏倚的可能性较小。结论IP-10鉴别活动性肺结核和潜伏性结核感染具有较高的敏感度和特异度。

Objective Systematically assessing the diagnostic value of interferon gamma induced protein 10(IP-10)for differentiating active tuberculosis from latent tuberculosis.Methods We searched PubMed,EMBASE,Cochrane Library and Web of science from their inception to March 2019,to include discriminating diagnostic tests of active tuberculosis from latent tuberculosis using IP-10.Two reviewers independently assessed study,extracted data,and assessed the quality of included studies.Data was analyzed by Stata 14.0.Results 10 articles,14 studies involving 773 patients were included.Meta-analysis showed that the pooled sensitivity,pooled specificity,pooled positive likelihood ratio,pooled negative likelihood ratio,diagnostic odds ratio,and ROC were 0.80(95%CI:0.71-0.87),0.90(95%CI:0.81-0.95),7.97(95%CI:4.07-15.61),0.22(95%CI:0.15-0.33),35.97(95%CI:14.93-86.65)and 0.91(95%CI:0.88-0.93),respectively.Deek′s results indicated that there were no possibility of publication of bias.Conclusion This study shows that IP-10 is a promising and reliable marker for differentiating active tuberculosis from latent tuberculosis.