The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies.
The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies.
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DOI：
10.1371/journal.pone.0131602
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Huang DH
中科院分区：
文献类型：
--
作者：
Hou TY;Wang SH;Liang SX;Jiang WX;Luo DD;Huang DH
血清1，3-β-D-葡聚糖（BG）检测有助于侵袭性真菌病（IFD）的早期诊断，并已被批准用于诊断。然而，关于BG的筛选性能的报告很少。我们对仅从前瞻性队列研究中提取的数据进行了荟萃分析，以评价BG检测在IFD诊断中的筛查性能。我们根据EORTC-MSG标准专门检索了4个数据库（PubMed、Web of Science、Elsevier和科克伦协作数据库）。共分析了11项研究中的1068例患者。Deeks漏斗图不对称性检验表明纳入研究的发表偏倚可能性较低（p = 0.055）。合并的敏感性、特异性、阳性似然比、阴性似然比、诊断比值比和汇总受试者工作特征曲线下面积，以及95%置信区间为0.75（0.63，0.84）、0.87（0.81，0.92）、5.85（3.96，8.63）、0.30（0.20，0.45）、19.53（11.16，34.18）和0.89（0.86，0.91）。这项荟萃分析的结果表明，BG测定是一种有用的筛查工具，具有高灵敏度和特异性，可用于区分有和无IFD的患者。在临床实践中，BG测定结果应与临床和微生物学结果一起评价。
The serum 1,3-beta-D-glucan (BG) assay aids in the early diagnosis of invasive fungal diseases (IFDs) and has been approved for their diagnosis. However, reports on the screening performance of BG are scarce. We performed a meta-analysis of data extracted from only prospective cohort studies to evaluate the screening performance of the BG assay in the diagnosis of IFDs. We specifically searched 4 databases (the PubMed, Web of Science, Elsevier, and Cochrane Collaboration databases) according to EORTC-MSG criteria. A total of 1068 patients in 11 studies were analyzed. Deeks’ funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively. The findings of this meta-analysis suggest that the BG assay is a useful screening tool with high sensitivity and specificity for discriminating between patients with and without IFDs. In clinical practice, BG assay results should be evaluated together with clinical and microbiological findings.
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