A Meta-analysis of the diagnosis value of latex agglutination test for the pulmonary cryptococcosis
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摘要: 目的 目前肺隐球菌病的诊断缺乏金标准,本研究旨在评价乳胶凝集试验对肺隐球菌病的诊断价值,为临床提供参考。 方法 检索中国知网、维普网、万方数据、Pubmed、EMbase、Web of Science、Sumsearch、TRIP、循证医学中心、CATbank、Cochrance组织、Evidence-baseed health、Netting the Evidence、社区预防服务指南、National Guideline Clearinghouse等国内外数据库或搜索引擎,收集探索乳胶凝集试验对肺炎隐球菌感染诊断价值的诊断性研究,筛选、评价文献并提取数据进行Meta分析,计算灵敏度、特异度、阳性似然比、阴性似然比以及诊断优势比等指标。 结果 本次研究共检索到287篇相关文献,最终共纳入7个文献,其中5篇研究来自中国,2篇来自日本;发表时间从1993-2012年;共计686例研究对象,其中肺隐球菌病152例,非肺隐球菌病534例。采用QUADAS评分标准评价纳入文献的方法学质量,纳入的7篇文献QUADAS评分均 ≥ 9分。使用Rev-Man 5.3软件进行数据分析,分析乳胶凝集试验诊断肺隐球菌病的临床价值。7篇文献的灵敏度为60.00%~100.00%,P<0.000 1,各研究的灵敏度之间存在统计学异质性,特异度为85.71%~100.00%,P<0.000 1,各研究的特异度之间存在统计学异质性。Meta分析结果显示,乳胶凝集试验诊断肺隐球菌病的合并灵敏度为0.80[0.72,0.86],合并特异度为0.99[0.98,1.00]。 结论 Meta分析结果证明,乳胶凝集试验对肺隐球菌病具有很高的诊断价值。Abstract: Objective At present,the diagnosis of pulmonary cryptococcosis is lack of gold standard.The aim of this study is evaluating the diagnostic value of latex agglutination test in the diagnosis of pulmonary cryptococcosis so as to provide reference for clinical. Methods The research about the diagnosis value of latex agglutination test for the pulmonary cryptococcosis on the domestic and overseas data bases or search engines were searched and screened,which included CNKI,VIP,WANFANG DATA,Pubmed,EMbase,Web of Science,Sumsearch,TRIP,Evidence Based Medicine Center,CATbank,Cochrance organization,Evidence-based health,Netting the Evidence,Guide for community preventive services and National Guideline Clearinghouse.The quality of articles was evaluated and the essential data was extracted from the eligible articles for the meta-analysis. Results A total of 287 articles were retrieved,and there were 7 eligible trials were analyzed in all.Five of them were from China,and 2 from Japan.The time of publication was from 1993 to 2012.A total of 686 subjects were included.Among them,152 cases were pulmonary cryptococcosis and 534 cases were non pulmonary cryptococcosis.The QUADAS standard were used to evaluate the quality of the articles enrolled in this study,and all the articles enrolled in this study got a QUADAS score ≥ 9.Clinical value of latex agglutination test in the diagnosis of pulmonary cryptococcosis were analyzed by Rev-Man 5.3 software.The sensitivity of the 7 articles were 60%-100%(P<0.001).The sensitivity of each study was statistically heterogeneous.The specificity of the 7articles were 85.71%-100.00%,the P value<0.001.And the specificity of each study was statistically heterogeneous.The results of Meta-analysis showed that the sensitivity was 0.80[0.72,0.86],specificity was 0.99[0.98,1.00]. Conclusion Meta analysis shows that it is not recommended for antibiotic using in pre-ERCP routinely.
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Key words:
- Latex agglutination test /
- Pulmonary cryptococcosis /
- Diagnosis /
- Meta-analysis
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