Diagnostic performance of biomarkers for differentiating active tuberculosis from latent tuberculosis: a systematic review and Bayesian network meta-analysis.
Ji Hun Jeong, Sung Ryul Shim, Sangah Han, Inhwan Hwang, Chunhwa Ihm
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引用次数: 0
Abstract
Background: PCR and culture tests are used together to confirm the diagnosis of active tuberculosis (TB). Due to the long culture period, if the PCR test is negative, it takes a significant amount of time for the culture result to be available. Interferon-γ release assays (IGRAs), which are widely used to diagnose TB or latent tuberculosis infection (LTBI), cannot effectively discriminate TB from LTBI. The purpose of this study is to analyze the diagnostic performance of various markers for differentiating between TB from LTBI.
Methods: PubMed-Medline, EMBASE, Cochrane Library, and Web of Science were searched up to the end of May 2024, without restrictions on publication date and population. Articles describing the diagnostic value of at least one biomarker for differentiating between TB and LTBI were included. The QUADAS-2 tool was used to assess study quality. Two independent researchers assessed the articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The network meta-analysis (NMA) was performed for diagnostic tools of 11 groups used to differentiate TB from LTBI.
Results: Out of 164 identified articles, 159 reports were included in the systematic review and 58 in the meta-analysis. Seventy results from 58 reports accounting for 9,291 participants were included. When measuring interleukin-2 (IL-2) after stimulation with latency antigen, the most significant odds ratio was shown in terms of sensitivity, specificity, positive predictive value and negative predictive value. The values were 9.46, 18.5, 11.30, and 9.61, respectively.
Conclusion: This study shows that the IL-2 level after stimulation with latent antigen is a potential biomarker for differentiating TB from LTBI.
背景：聚合酶链反应和培养试验共同用于确认活动性肺结核（TB）的诊断。由于培养周期较长，如果PCR检测为阴性，则需要很长时间才能获得培养结果。干扰素γ释放试验（IGRAs）被广泛用于诊断结核病或潜伏性结核感染（LTBI），但不能有效区分结核病和LTBI。本研究的目的是分析各种标志物对TB和LTBI的诊断性能。方法：检索截至2024年5月底的PubMed-Medline、EMBASE、Cochrane Library和Web of Science，不限制发表日期和人群。文章描述了至少一种生物标志物的诊断价值，用于区分结核和LTBI。采用QUADAS-2工具评估研究质量。两名独立研究人员使用系统评价和荟萃分析（PRISMA）指南的首选报告项目评估了这些文章。网络荟萃分析（NMA）对11组用于区分TB和LTBI的诊断工具进行了分析。结果：164篇文献中，159篇纳入系统评价，58篇纳入meta分析。其中包括来自58份报告的70个结果，涉及9291名参与者。在检测潜伏期抗原刺激后的白细胞介素-2 （IL-2）时，在敏感性、特异性、阳性预测值和阴性预测值方面的比值比最为显著。分别为9.46、18.5、11.30、9.61。结论：潜伏抗原刺激后的IL-2水平是鉴别TB与LTBI的潜在生物标志物。系统评审注册：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024542996。
期刊介绍：
Frontiers in Microbiology is a leading journal in its field, publishing rigorously peer-reviewed research across the entire spectrum of microbiology. Field Chief Editor Martin G. Klotz at Washington State University is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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