Diagnostic test accuracy of anti-glycopeptidolipid-core IgA antibodies for Mycobacterium avium complex pulmonary disease: systematic review and meta-analysis.
Diagnostic test accuracy of anti-glycopeptidolipid-core IgA antibodies for Mycobacterium avium complex pulmonary disease: systematic review and meta-analysis.
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DOI：
10.1038/srep29325
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发表时间：
2016-07-04
影响因子：
4.6
通讯作者：
Kaneko T
中科院分区：
文献类型：
--
作者：
Shibata Y;Horita N;Yamamoto M;Tsukahara T;Nagakura H;Tashiro K;Watanabe H;Nagai K;Nakashima K;Ushio R;Ikeda M;Narita A;Kanai A;Sato T;Kaneko T
目前，用于诊断鸟分枝杆菌复合体（MAC）的抗糖肽脂（GPL）-核心伊加抗体测定试剂盒是市售的。我们进行了这项系统回顾和荟萃分析，以揭示抗GPL核心伊加抗体对MAC肺病（MAC-PD）的精确诊断准确性。我们系统地检索了能够提供抗GPL核心伊加抗体对临床诊断MAC-PD的敏感性和特异性数据的报告。使用双变量模型估计诊断测试准确度。在我们通过初步检索发现的257篇文献中，我们最终纳入了16篇报告，包括1098例参考阳性受试者和2270例参考阴性受试者。诊断优势比为24.8（95%CI 11.6-52.8，I2 = 5.5%），分层汇总受试者工作特征曲线下面积为0.873（95%CI 0.837-0.913）。当临界值为0.7 U/mL时，灵敏度和特异性的汇总估计值分别为0.696（95% CI 0.621-0.761）和0.906（95% CI 0.836-0.951）。阳性和阴性似然比分别为7.4（95% CI 4.1-13.8）和0.34（95% CI 0.26-0.43）。严格的临床诊断标准可能是索引测试假阳性的原因。指数试验具有较好的诊断准确性，有助于以临界值判定MAC-PD。
Currently, an anti-glycopeptidolipid (GPL)-core IgA antibody assay kit for diagnosing Mycobacterium avium complex (MAC) is commercially available. We conducted this systematic review and meta-analysis to reveal the precise diagnostic accuracy of anti-GPL-core IgA antibodies for MAC pulmonary disease (MAC-PD). We systematically searched reports that could provide data for both sensitivity and specificity by anti-GPL-core IgA antibody for clinically diagnosed MAC-PD. Diagnostic test accuracy was estimated using the bivariate model. Of the 257 articles that we had found through primary search, we finally included 16 reports consisted of 1098 reference positive subjects and 2270 reference negative subjects. The diagnostic odds ratio was 24.8 (95% CI 11.6–52.8, I2 = 5.5%) and the area under the hierarchical summary receiver operating characteristic curves was 0.873 (95% CI 0.837–0.913). With a cutoff value of 0.7 U/mL, the summary estimates of sensitivity and specificity were 0.696 (95% CI 0.621–0.761) and 0.906 (95% CI 0.836–0.951), respectively. The positive and negative likelihood ratios were 7.4 (95% CI 4.1–13.8) and 0.34 (95% CI 0.26–0.43), respectively. The demanding clinical diagnostic criteria may be a cause of false positive of the index test. The index test had good overall diagnostic accuracy and was useful to ruling in MAC-PD with the cutoff value.