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Diagnostic Value of T-SPOT.TB Assay for Tuberculous Peritonitis: A Meta-Analysis

机译:T-Spot.tb测定对结核性腹膜炎的诊断价值:META分析

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Background Tuberculous peritonitis (TP) is a common form of abdominal tuberculosis (TB). Diagnosing TP remains challenging in clinical practice. The aim of the present meta-analysis was to evaluate the diagnostic accuracy of peripheral blood (PB) T-SPOT and peritoneal fluid (PF) T-SPOT for diagnosing TP. Methods PubMed, EmBase, Cochrane, Scopus, Google scholar, China national knowledge internet, and Wan-Fang databases were searched for relevant articles from August 1, 2005 to July 5, 2020. Statistical analysis was performed using Stata, Revman, and Meta-Disc software. Diagnostic parameters including pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were determined. Summary receiver operating characteristic curve was used to determine the area under the curve (AUC). Results Twelve studies were eligible and included in the meta-analysis. The analysis showed that the pooled sensitivity and specificity of PB T-SPOT in diagnosing TP were 0.91 (95% CI, 0.88-0.94) and 0.78 (95% CI, 0.73-0.81), respectively, while the pooled PLR, NLR, and DOR were 4.05 (95% CI, 2.73-6.01), 0.13 (95% CI, 0.07-0.23), and 37.8 (95% CI, 15.04-94.98), respectively. On the other hand, the summary estimates of sensitivity, specificity, PLR, NLR, and DOR of PF T-SPOT for TP diagnosis were 0.90 (95% CI, 0.85-0.94), 0.78 (95% CI, 0.72-0.83), 6.35 (95% CI, 2.67-15.07), 0.14 (95% CI, 0.09-0.21), and 58.22 (95% CI, 28.76-117.83), respectively. Furthermore, the AUC of PB T-SPOT and PF T-SPOT for TP diagnosis were 0.91 and 0.94, respectively. Conclusions Our results indicate that both PB T-SPOT and PF T-SPOT can be served as sensitive approaches for the diagnosis of TP. However, the unsatisfactory specificities of these two methods limit their application as rule-in tests for TP diagnosis. Furthermore, the standardization of the operating procedure of PF T-SPOT is further needed.
机译:背景技术结核腹膜炎(TP)是腹部结核(TB)的常见形式。诊断TP在临床实践中仍然具有挑战性。目前的荟萃分析的目的是评估外周血(PB)T-点和腹膜液(PF)T-诊断TP的诊断准确性。方法采用PubMed,Embase,Cochrane,Scopus,Google Scholar,中国国家知识互联网和WAN-Fang数据库,从2005年8月1日至7月5日,在2020年7月5日开始。使用Stata,Revman和Meta-进行统计分析光盘软件。确定了包括汇集灵敏度,特异性,正似然比(PLR),负似然比(NLR)和诊断差距比(DOR)的诊断参数。概要接收器操作特性曲线用于确定曲线(AUC)下的区域。结果12项研究符合条件并包含在META分析中。分析表明,诊断TP中Pb T斑的汇集性和特异性分别为0.91(95%CI,0.88-0.94)和0.78(95%CI,0.73-0.81),而汇集的PLR,NLR和DOR分别为4.05(95%CI,2.73-6.01),0.13(95%CI,0.07-0.23)和37.8(95%CI,15.04-94.98)。另一方面,TP诊断PF T斑的敏感性,特异性,PLR,NLR和DOR的总结估计为0.90(95%CI,0.85-0.94),0.78(95%CI,0.72-0.83), 6.35(95%CI,2.67-15.07),0.14(95%CI,0.09-0.21)和58.22(95%CI,28.76-117.83)。此外,Pb T-斑点的AUC和TP诊断的PF T-斑点分别为0.91和0.94。结论我们的结果表明,Pb T-斑和PF T斑都可以作为诊断TP的敏感方法。然而,这两种方法的不令人满意的特异性将其应用限制为TP诊断的规则试验。此外,还需要进一步需要PF T-斑点的操作方法的标准化。

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