Pretransplantation Soluble CD30 Level As a Predictor of Acute Rejection in Kidney Transplantation: A Meta-Analysis
Pretransplantation Soluble CD30 Level As a Predictor of Acute Rejection in Kidney Transplantation: A Meta-Analysis
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移植前可溶性 CD30 水平作为肾移植急性排斥反应的预测因子：荟萃分析
DOI：
10.1097/tp.0b013e31826784ad
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发表时间：
2012-11-15
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：
Chen, Yile;Tai, Qiang;He, Xiaoshun
背景：移植前高水平的可溶性CD30(SCD30)是否可以作为肾移植急性排斥反应(AR)的预测指标，目前仍存在争议。在此，我们对肾移植中sCD30对AR的预测效果进行了荟萃分析。方法检索PubMed(1966-2012)、EMBASE(1988-2012)和Web of Science(1986-2012)数据库中有关sCD30预测肾移植后AR的研究。在仔细审查符合条件的研究后，对sCD30的敏感度、特异度和其他准确性指标进行了汇总。用一个概括性的接收器工作特性曲线来表示总体测试性能。结果12项研究共纳入2507名患者，符合纳入标准。对移植前sCD30预测排斥反应风险的综合估计较差，灵敏度为0.70(95%可信区间，0.66-0.74)，特异度为0.48(95%可信区间，0.46-0.50)，阳性似然比为1.35(95%可信区间，1.20-1.53)，阴性似然比为0.68(95%可信区间，0.55-0.84)，诊断优势比为2.07(95%可信区间，1.54-2.80)。受试者操作特征曲线的曲线下面积为0.60，表明血清sCD30水平预测AR风险患者的总体准确性较差。结论Meta分析结果显示，移植前sCD30预测移植后AR的准确性较差。需要进行前瞻性研究，以明确这项测试在识别移植受者AR风险方面的有效性。
Background The question of whether high pretransplantation soluble CD30 (sCD30) level can be a predictor of kidney transplant acute rejection (AR) is under debate. Herein, we performed a meta-analysis on the predictive efficacy of sCD30 for AR in renal transplantation. Methods PubMed (1966–2012), EMBASE (1988–2012), and Web of Science (1986–2012) databases were searched for studies concerning the predictive efficacy of sCD30 for AR after kidney transplantation. After a careful review of eligible studies, sensitivity, specificity, and other measures of the accuracy of sCD30 were pooled. A summary receiver operating characteristic curve was used to represent the overall test performance. Results Twelve studies enrolling 2507 patients met the inclusion criteria. The pooled estimates for pretransplantation sCD30 in prediction of allograft rejection risk were poor, with a sensitivity of 0.70 (95% confidence interval (CI), 0.66–0.74), a specificity of 0.48 (95% CI, 0.46–0.50), a positive likelihood ratio of 1.35 (95% CI, 1.20–1.53), a negative likelihood ratio of 0.68 (95% CI, 0.55–0.84), and a diagnostic odds ratio of 2.07 (95% CI, 1.54–2.80). The area under curve of the summary receiver operating characteristic curve was 0.60, indicating poor overall accuracy of the serum sCD30 level in the prediction of patients at risk for AR. Conclusions The results of the meta-analysis show that the accuracy of pretransplantation sCD30 for predicting posttransplantation AR was poor. Prospective studies are needed to clarify the usefulness of this test for identifying risks of AR in transplant recipients.