Performance of Polymerase Chain Reaction Techniques Detecting Granzyme B in the Diagnosis of Acute Renal Rejection: A Meta-Analysis
Performance of Polymerase Chain Reaction Techniques Detecting Granzyme B in the Diagnosis of Acute Renal Rejection: A Meta-Analysis
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DOI：
10.1097/tp.0b013e318287d818
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发表时间：
2013-05
期刊：
影响因子：
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通讯作者：
Yushu Shang;W. Ju;Yuan Kong;W. Liang;Xiaoting Ling;Zhiyong Guo;Xiaoshun He
中科院分区：
文献类型：
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作者：
Yushu Shang;W. Ju;Yuan Kong;W. Liang;Xiaoting Ling;Zhiyong Guo;Xiaoshun He
背景研究表明，颗粒酶B在急性排斥反应中表达上调，为建立一种无创、可靠的诊断方法提供了希望。然而，到目前为止，诊断性能还没有得到系统的评估。方法应用计算机检索电子数据库2012年2月1日以前的相关资料。报道了应用聚合酶链式反应技术检测颗粒酶B在急性肾排斥患者中的诊断性能的临床研究。从相关材料的每个数据集中提取颗粒酶B检测鉴定的真阳性、真阴性、假阳性和假阴性病例的数据。将发表年份、样本来源、信使核糖核酸定量方法和看家基因作为潜在的混杂变量。结果共纳入14篇研究，共514例。颗粒酶B的综合诊断敏感性为0.76(95%可信区间为0.69~0.81)，综合特异度为0.87(95%可信区间为0.83~0.9)，诊断优势比为19.27(95%可信区间为1.2~195.00)，受试者工作特征曲线下面积为0.8900±0.0270。对潜在变量的单变量分析显示没有统计学上的显著差异。结论尽管研究间存在差异，颗粒酶B基因在诊断急性排斥反应中具有敏感性和特异性，且在方法学变化的情况下表现出一致性。然而，临床实践需要仔细考虑和其他补充测试。
Background Studies have shown that granzyme B expression was up-regulated during acute renal rejection, which provides hopes for a noninvasive and reliable diagnostic method. However, the diagnostic performance has not been assessed systematically so far. Methods Relevant materials were searched from electronic databases before February 1, 2012. Clinical studies that reported the diagnostic performance of detecting granzyme B mRNA using polymerase chain reaction techniques in acute renal rejection patients were included. The data of true-positive, true-negative, false-positive, and false-negative cases identified by granzyme B detection were extracted from each data set of the relevant materials. The publication year, sample origin, mRNA quantification method, and housekeeping gene were extracted as potential confounding variables. Results Fourteen studies with a total of 514 cases were included. The overall diagnostic performance of granzyme B was pooled sensitivity of 0.76 (95% confidence interval [CI], 0.69–0.81), pooled specificity of 0.87 (95% CI, 0.83–0.90), diagnostic odds ratio of 19.27 (95% CI, 1.20–195.00), and area under the summary receiver operating characteristic curve value of 0.8900±0.0270. The univariate analysis of potential variables showed no statistically significant variations. Conclusions Despite interstudy variability, granzyme B mRNA demonstrated both sensitivity and specificity in the diagnosis of acute rejection and showed consistency under circumstances of methodologic changes. However, the clinical practice requires careful consideration and other supplementary tests.