血清KL-6对类风湿关节炎相关肺间质病变诊断价值的Meta分析

A Meta-analysis of the Diagnostic Value of Serum KL-6 for Rheumatoid Arthritis Associated Interstitial Lung Lesions

目的采用Meta分析法系统评价KL-6对类风湿关节炎相关间质性病变(RA-ILD)的诊断价值。方法通过计算机检索自建库以来至2024年6月25日在中国知网(CNKI)、万方(Wanfang)、维普(VIP)中国生物医学文献数据库(CBM)、PubMed、Web of Science、EMbase、Cochrane Library等数据库有关血清KL-6检测RA-ILD的研究,由两名研究者进行独立检索筛选文献、提取数据、质量评价,利用Meta-Disc软件判断文章是否存在阈值效应,Cochran-Q检验及I2结果判断是否存在非阈值效应引起的异质性,通过Stata 16.0合并效应量,绘制Deek’s漏斗图评估是否存在发表偏倚。结果共检索出文献306篇,经筛选后共纳入11篇研究,共1260例RA患者参与研究,经Meta分析合并的效应量:合并特异性为0.89(95%CI 0.82~0.93)、合并PLR为7.45(95%CI 4.33~12.82)、合并NLR为0.19(95%CI 0.13~0.29)、合并DOR为38.39(95%CI 16.13~91.36)。Deek’S漏斗图显示无明显发表偏倚(P=0.16)。结论血清KL-6诊断RA-ILD的灵敏度与特异性均较高,具有良好应用前景。

Objective To systematically evaluate the diagnostic value of KL-6 for rheumatoid arthritis associated interstitial lesions(RA-ILD).Methods We applied meta-analysis methods in this study.Previous studies of KL-6 detection of RA-ILD were searched from the date of the establishment of the database to June 25,2024,including CNKI,Wanfang,VIP CBM,PubMed,Web of Science,Embase,Cochrane Library,Web of Scienc,and EMbase.Two researchers conducted independent searches to screen the literature,extract the data,and evaluate the quality.Meta-Disc software was used to determine whether there was a threshold effect in the articles.Cochran-Q test and I 2 results were applied to determine whether there was non-heterogeneity caused by threshold effect,combining effect sizes by Stata 16.0.Deek’s funnel plot was drawn to assess the presence of publication bias.Results A total of 306 articles were retrieved from previous literatures,and a total of 11 studies were included after screening process,with a total of 1260 RA patients participating in the study.The effect sizes combined by meta-analysis showed that:the combined specificity was 0.89(95%CI 0.82-0.93),combined PLR was 7.45(95%CI 4.33-12.82),combined NLR was 0.19(95%CI 0.13-0.29),and combined DOR was 38.39(95%CI 16.13-91.36).Deek’S funnel plot showed no significant publication bias(P=0.16).Conclusion KL-6 has a high sensitivity and specificity in diagnosing RA-ILD,and has a good application prospect.