Can Immune Cell Function Assay Identify Patients at Risk of Infection or Rejection? A Meta-Analysis
Can Immune Cell Function Assay Identify Patients at Risk of Infection or Rejection? A Meta-Analysis
复制标题
免疫细胞功能检测可以识别有感染或排斥风险的患者吗？
DOI：
10.1097/tp.0b013e3182466248
复制
发表时间：
2012-04-15
期刊：
影响因子：
6.2
通讯作者：
He, Xiaoshun
中科院分区：
文献类型：
--
作者：
Ling, Xiaoting;Xiong, Jun;He, Xiaoshun
背景Cylex ImmuKnow细胞功能测定（CICFA）被认为是一种可能的工具，用于识别移植受者的感染和排斥反应。然而，CICFA的预测能力仍然不清楚。方法.在此，我们进行了一项荟萃分析，以评估CICFA在识别移植后感染和排斥反应风险方面的有效性。在仔细审查合格的研究，灵敏度，特异性和其他措施的准确性CICFA合并。使用总结受试者工作特征曲线表示总体试验性能。结果9项研究符合纳入标准。CICFA在识别感染风险方面的合并估计值较差，敏感性为0.58（95%置信区间[CI]：0.52-0.64），特异性为0.69（95% CI：0.66-0.70），阳性似然比为2.37（95%CI：1.90-2.94），阴性似然比为0.39（95%CI：0.16-0.70），诊断优势比为7.41（95%CI：3.36-16.34）。CICFA在识别排斥风险方面的汇总估计值也相当差，敏感性为0.43（95% CI：0.34-0.52），特异性为0.75（95% CI：0.72-0.78），阳性似然比为1.30（95% CI：0.74-2.28），阴性似然比为0.96（95% CI：0.85-1.07），诊断优势比为1.19（95% CI：0.65-2.20）。结论目前的证据表明，CICFA无法识别有感染或排斥风险的个体。仍需要进一步的研究来阐明这种检测在识别移植受者感染和排斥风险方面的有用性。
Background. The Cylex ImmuKnow cell function assay (CICFA) is being considered as a possible tool for identification of infection and rejection in transplant recipients. However, the predictive capability of CICFA is still unclear. Methods. Herein, we performed a meta-analysis to assess the efficacy of CICFA in identifying risks of infection and rejection posttransplantation. After a careful review of eligible studies, sensitivity, specificity, and other measures of the accuracy of CICFA were pooled. Summary receiver operating characteristic curves were used to represent the overall test performance. Results. Nine studies met the inclusion criteria. The pooled estimates for CICFA in identification of infection risk were poor, with a sensitivity of 0.58 (95% confidence interval [CI]: 0.52–0.64), a specificity of 0.69 (95% CI: 0.66–0.70), a positive likelihood ratio of 2.37 (95% CI: 1.90–2.94), a negative likelihood ratio of 0.39 (95% CI: 0.16–0.70), and a diagnostic odds ratio of 7.41 (95% CI: 3.36–16.34). The pooled estimates for CICFA in identifying risk of rejection were also fairly poor with a sensitivity of 0.43 (95% CI: 0.34–0.52), a specificity of 0.75 (95% CI: 0.72–0.78), a positive likelihood ratio of 1.30 (95% CI: 0.74–2.28), a negative likelihood ratio of 0.96 (95% CI: 0.85–1.07), and a diagnostic odds ratio of 1.19 (95% CI: 0.65–2.20). Conclusion. The current evidence suggests that CICFA is not able to identify individuals at risk of infection or rejection. Additional studies are still needed to clarify the usefulness of this test for identifying risks of infection and rejection in transplant recipients.