The accuracy of presepsin (sCD14-ST) for the diagnosis of sepsis in adults: a meta-analysis.
The accuracy of presepsin (sCD14-ST) for the diagnosis of sepsis in adults: a meta-analysis.
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DOI：
10.1186/s13054-015-1032-4
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发表时间：
2015-09-11
期刊：
影响因子：
--
通讯作者：
Xie LX
中科院分区：
文献类型：
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作者：
Zhang X;Liu D;Liu YN;Wang R;Xie LX
脓毒症的早期诊断仍然是一个挑战。最近，可溶性分化簇 14 亚型 (sCD14-ST)，也称为 presepsin，已被确定为脓毒症的潜在生物标志物。我们进行了一项荟萃分析，以评估 presepsin 对全身炎症患者脓毒症的诊断准确性。我们系统地检索了 PubMed、Embase、Web of Knowledge 和 Cochrane 数据库。如果评估 presepsin 对患有全身炎症反应综合征 (SIRS) 的成年患者脓毒症的诊断准确性，则纳入研究。此外，根据这些结果构建了 2 × 2 列联表。两位作者独立评判研究并提取数据。使用双变量荟萃分析模型计算 presepsin 对脓毒症的诊断准确性。采用Q检验和I2指数来检验异质性。本研究纳入了八项研究，共涉及 1,815 名患者。汇总敏感性、特异性、诊断比值比、阳性似然比和阴性似然比分别为 0.86 (95 % CI: 0.79-0.91)、0.78 (95 % CI: 0.68-0.85)、22 (95 % CI: 10–48)、3.8 (95 % CI: 2.6-5.7) 和 0.18 (95 % CI：0.11-0.28)，分别。汇总受试者工作特征曲线下面积为 0.89 (95% CI: 0.86–0.92)。荟萃回归分析显示，连续的患者选择、样本量和设置显着解释了敏感性的异质性。我们的研究结果表明，presepsin 对脓毒症的诊断具有非常好的诊断准确性（AUC=0.89）。然而，需要对脓毒症诊断的所有临床指标进行全面评估，并在病程中不断重新评估 presepsin。
The early diagnosis of sepsis remains a challenge. Recently, soluble cluster of differentiation 14 subtype (sCD14-ST), also known as presepsin, has been identified as a potential biomarker of sepsis. We performed a meta-analysis to assess the diagnostic accuracy of presepsin for sepsis in patients with systemic inflammation. We systematically searched the PubMed, Embase, Web of Knowledge and Cochrane databases. Studies were included if they assessed the diagnostic accuracy of presepsin for sepsis in adult patients with systemic inflammatory response syndrome (SIRS). Furthermore, a 2 × 2 contingency table was constructed based on these results. Two authors independently judged the studies and extracted the data. The diagnostic accuracy of presepsin in sepsis was calculated using a bivariate meta-analysis model. The Q-test and I2 index were used to test the heterogeneity. Eight studies involving a total of 1,815 patients were included in the present study. The pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio and negative likelihood ratio were 0.86 (95 % CI: 0.79-0.91), 0.78 (95 % CI: 0.68-0.85), 22 (95 % CI: 10–48), 3.8 (95 % CI: 2.6-5.7), and 0.18 (95 % CI: 0.11-0.28), respectively. The area under the summary receiver operator characteristic curve was 0.89 (95 % CI: 0.86–0.92). Meta-regression analysis revealed that consecutive patient selection, sample size and setting significantly accounted for the heterogeneity of sensitivity. Our findings suggest that presepsin exhibits very good diagnostic accuracy (AUC=0.89) for the diagnosis for sepsis. Nevertheless, an overall assessment of all the clinical indexes for sepsis diagnosis and continual re-evaluation of presepsin during the course of the disease are needed.