Assessment by meta-analysis of interferon-gamma for the diagnosis of tuberculous peritonitis

作者：Su, Si-Biao; Qin, Shan-Yu; Guo, Xiao-Yun; Luo, Wei; Jiang, Hai-Xing^*

来源：World Journal of Gastroenterology, 2013, 19(10): 1645-1651.

DOI：10.3748/wjg.v19.i10.1645

• Tuberculosis
• Tuberculous peritonitis
• Interferon-gamma
• Diagnosis
• Meta-analysis

AIM: To investigate the performance and diagnostic accuracy of interferon-gamma (IFN-gamma) for tuberculous peritonitis (TBP) by meta-analysis.
METHODS: A systematic search of English language studies was performed. We searched the following electronic databases: MEDLINE, EMBASE, Web of Science, BIOSIS, LILACS and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IFN-gamma concentration in the diagnosis of peritoneal effusion were pooled using random-effects models. Receiver operating characteristic (ROC) curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.
RESULTS: Six studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92. Analysis of IFN-gamma level for TBP diagnosis yielded a summary estimate: sensitivity, 0.93 (95% CI, 0.87-0.97); specificity, 0.99 (95% CI, 0.97-1.00); positive likelihood ratio (PLR), 41.49 (95% CI, 18.80-91.55); negative likelihood ratio (NLR), 0.11 (95% CI, 0.06-0.19); and diagnostic odds ratio (DOR), 678.02 (95% CI, 209.91-2190.09). chi(2) values of the sensitivity, specificity, PLR, NLR and DOR were 5.66 (P = 0.3407), 6.37 (P = 0.2715), 1.38 (P = 0.9265), 5.46 (P = 0.3621) and 1.42 (P = 0.9220), respectively. The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97. The area under the curve was 0.99. The evaluation of publication bias was not significant (P = 0.922).
CONCLUSION: IFN-gamma may be a sensitive and specific marker for the accurate diagnosis of TBP. The level of IFN-gamma may contribute to the accurate differentiation of tuberculosis (TB) ascites from non-TB ascites.

• 出版日期2013-3-14
• 单位广西医科大学