Performance of Polymerase Chain Reaction Techniques Detecting Perforin in the Diagnosis of Acute Renal Rejection: A Meta-Analysis
Performance of Polymerase Chain Reaction Techniques Detecting Perforin in the Diagnosis of Acute Renal Rejection: A Meta-Analysis
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聚合酶链式反应技术检测穿孔素在急性肾排斥诊断中的表现：荟萃分析
DOI：
10.1371/journal.pone.0039610
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发表时间：
2012-06
期刊：
影响因子：
3.7
通讯作者：
He, Xiaoshun
中科院分区：
文献类型：
--
作者：
Shang, Yushu;Ju, Weiqiang;Kong, Yuan;Schroder, Paul M.;Liang, Wenhua;Ling, Xiaoting;Guo, Zhiyong;He, Xiaoshun
背景以往的研究表明，急性肾排斥反应中穿孔素的表达上调，这为急性排斥反应的无创、可靠诊断提供了希望。然而，对穿孔素作为急性肾排斥反应的诊断标志物的价值的系统评估尚未进行。我们进行了这项荟萃分析，以记录穿孔蛋白mRNA检测的诊断性能，并确定可能影响性能的潜在变量。方法/主要发现从电子数据库中提取报道perforin mRNA检测对急性肾排斥患者诊断性能的相关资料。在仔细评估本分析中包含的研究后，从每个数据集中收集通过穿孔素mRNA检测识别的急性肾排斥反应的真阳性、真阴性、假阳性和假阴性病例的数量。发表年份、样本来源、mRNA定量方法和管家基因也被提取为潜在的混杂变量。本荟萃分析纳入了14项研究，共501例肾移植受试者。perforin mRNA检测的总体表现为：合并灵敏度为0.83(95%可信区间：0.78 ~ 0.88)；合并特异性为0.86(95%可信区间：0.82 ~ 0.90)；诊断优势比28.79(95%可信区间：16.26 ~ 50.97)；总体受试者工作特征曲线下面积为0.9107±0.0174。潜在变量的单因素分析显示诊断效能有一定变化，但差异均无统计学意义。结论/意义尽管研究间存在差异，但在方法学改变的情况下，聚合酶链反应检测穿孔素mRNA的检测性能是一致的，并且在检测急性肾排斥反应方面具有敏感性和特异性。这些结果表明，穿孔蛋白mRNA检测作为肾移植受体急性排斥反应的可靠标志物具有很大的诊断潜力。
Background Studies in the past have shown that perforin expression is up-regulated during acute renal rejection, which provided hopes for a non-invasive and reliable diagnostic method to identify acute rejection. However, a systematic assessment of the value of perforin as a diagnostic marker of acute renal rejection has not been performed. We conducted this meta-analysis to document the diagnostic performance of perforin mRNA detection and to identify potential variables that may affect the performance. Methodology/Principal Findings Relevant materials that reported the diagnostic performance of perforin mRNA detection in acute renal rejection patients were extracted from electronic databases. After careful evaluation of the studies included in this analysis, the numbers of true positive, true negative, false positive and false negative cases of acute renal rejection identified by perforin mRNA detection were gathered from each data set. The publication year, sample origin, mRNA quantification method and housekeeping gene were also extracted as potential confounding variables. Fourteen studies with a total of 501 renal transplant subjects were included in this meta-analysis. The overall performance of perforin mRNA detection was: pooled sensitivity, 0.83 (95% confidence interval: 0.78 to 0.88); pooled specificity, 0.86 (95% confidence interval: 0.82 to 0.90); diagnostic odds ratio, 28.79 (95% confidence interval: 16.26 to 50.97); and area under the summary receiver operating characteristic curves value, 0.9107±0.0174. The univariate analysis of potential variables showed some changes in the diagnostic performance, but none of the differences reached statistical significance. Conclusions/Significance Despite inter-study variability, the test performance of perforin mRNA detected by polymerase chain reaction was consistent under circumstances of methodological changes and demonstrated both sensitivity and specificity in detecting acute renal rejection. These results suggest a great diagnostic potential for perforin mRNA detection as a reliable marker of acute rejection in renal allograft recipients.
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DOI：
10.1136/bmj.320.7244.1269/a
发表时间：
2000-05
期刊：
BMJ : British Medical Journal
影响因子：
--
作者：
通讯作者：
--
影响因子：
2.1
作者：
Dias, ECA;Veronese, FJV;Manfro, RC
通讯作者：
Manfro, RC
影响因子：
6.2
作者：
Dugré, FJ;Gaudreau, S;Roy, R
通讯作者：
Roy, R
影响因子：
19.6
作者：
Aquino-Dias, E. C.;Joelsons, G.;Manfro, R. C.
通讯作者：
Manfro, R. C.
影响因子：
3.7
作者：
Ozbay, A.;Torring, C.;Carstens, J.
通讯作者：
Carstens, J.