Diagnostic value of circular RNAs in colorectal cancer: A systematic review and meta-analysis

PurposeMounting studies has revealed that circular RNAs (circRNAs) play a key role in tumorigenesis and might serve as promising biomarkers for cancer diagnosis. However, the diagnostic value of circRNAs in colorectal cancer (CRC) remains to be precisely elucidated.MethodsAll relevant literatures were searched using Cochrane Library, PubMed, Web of Science, EMBASE, CNKI, and WanFang databases up to June 2019. The quality of eligible studies was assessed in accordance with the Quality Assessment of Diagnostic Accuracy Studies-2 system. The summary receiver operator characteristic curve (SROC) and area under SROC (AUC) were applied for the quantitative assessment of diagnostic performance. Threshold effect, subgroup analysis, and meta-regression were adopted to explore the sources of heterogeneity. Deeks’ funnel plot and sensitivity analysis were conducted to examine the publication bias and stability of meta-analysis, respectively.ResultsA total of 13 eligible studies involving 2190 subjects and 14 different kinds of circRNAs were enrolled. The pooled sensitivity, specificity, and AUC were 0.78 [95% confidential interval (CI): 0.70-0.84], 0.71 (95% CI: 0.65-0.76), and 0.80 (95% CI: 0.76-0.83), respectively. Subgroup analysis showed that studies involving ≥ 100 cases had higher sensitivity but lower specificity than those involving < 100 cases. Meta-regression revealed that sample size might be the potential source of heterogeneity. Sensitivity analysis and Deeks’ funnel plot indicated that our results were relatively robust and had no publication bias.ConclusionCircRNAs possess relatively moderate diagnostic accuracy and might serve as potential diagnostic biomarkers for colorectal cancer. Future large-scale studies are needed to confirm the diagnostic value of circRNAs.     

Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis

IntroductionTuberculous meningitis (TBM) is still a great challenge to global public health. As conventional diagnostic methods for TBM are unsatisfactory, interferon-γ release assays (IGRAs) have been introduced for TBM diagnosis tentatively. However, the role of IGRAs for diagnosing TBM remains unclear. Thus, we systematically evaluated the diagnostic performance of cerebrospinal fluid (CSF) and peripheral blood (PB) IGRAs in TBM to fill this blank.Material and methodsRelevant studies were systematically searched in both foreign and Chinese databases up to March 2018. Studies in which TBM diagnosis was based on microbiological or clinical criteria were included. The quality of the included studies was assessed through the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Main outcome measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR), were pooled statistically using random effects models. The potential heterogeneity was explored by threshold effect analysis, subgroup analyses and meta-regression. Funnel plots and Egger’s test were used to test the potential publication bias. Statistical analyses were performed using Stata and Meta-DiSc software.ResultsTwenty-six out of 656 publications were eligible for meta-analysis, including 1892 participants in total. The pooled estimates of PB IGRAs for TBM diagnosis are as follows: sensitivity: 0.81 (95% CI: 0.78–0.84); specificity: 0.76 (95% CI: 0.73–0.78); PLR: 4.23 (95% CI: 2.95–6.07); NLR: 0.24 (95% CI: 0.19–0.32) and DOR: 21.06 (11.91-37.24). The corresponding estimates for CSF IGRAs were obtained: sensitivity: 0.81 (95% CI: 0.76–0.85); specificity: 0.89 (95% CI: 0.86–0.92); PLR: 7.87 (95% CI: 4.98–12.46); NLR: 0.19 (95% CI: 0.13–0.29); and DOR: 47.74 (25.02–91.12).ConclusionsThe diagnostic performance of IGRAs is suboptimal. In terms of cost, turn-around time and accessibility, these assays are unsuitable for use as biomarkers for TBM diagnosis.     

Accuracy of interferon-γ-induced protein 10 for diagnosing latent tuberculosis infection: a systematic review and meta-analysis

BackgroundEffective diagnostic methods for detecting latent tuberculosis infection (LTBI) are important for its eradication. A number of studies have evaluated the use of interferon-γ-induced protein 10 (IP-10), which is elevated after tuberculosis infection, as a biomarker for LTBI, but conclusive results regarding its effectiveness have not been reported.ObjectivesOur objective was to assess the diagnostic value of IP-10 for LTBI.Data sourcesWe searched the PubMed, Embase, the Cochrane Library and Web of Science databases to find eligible studies.Study eligibility criteriaWe included cohort, case–control and cross-sectional studies that evaluated IP-10 in LTBI participants in comparison with tuberculin skin tests (TST) and interferon-γ release assays (IGRA).ParticipantsIndividuals with LTBI and uninfected participants.InterventionsIP-10 (index test) compared with TST and IGRA (reference standard) for diagnosing LTBI.MethodsPubMed, Embase, the Cochrane Library, and Web of Science databases were searched up to June 2018. A hierarchical summary receiver operating characteristic (HSROC) model was used to evaluate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and HSROC curve for the diagnostic efficiency of IP-10.ResultsTwelve studies including 1023 participants and 1122 samples were included. The overall pooled sensitivity was 0.85 (95% CI 0.80–0.88), specificity was 0.89 (95% CI 0.84–0.92), PLR was 7.55 (95% CI 5.20–10.97), NLR was 0.17 (95% CI 0.13–0.22) and DOR was 44.23 (95% CI 28.86–67.79), indicating a high accuracy for diagnosing LTBI. Based on a meta-regression analysis, high-burden countries, study design, IP-10 method, reference standard and the IP-10 cut-off could not explain the heterogeneity (p >0.05).ConclusionsOur results suggested that IP-10 is a promising biomarker for the diagnosis of LTBI.     

Diagnostic value of circulating microRNAs for osteosarcoma in Asian populations: a meta-analysis

A large number of studies have provided new insights into the diagnostic value of circulating microRNAs (miRNA) for osteosarcoma (OS), one of the most common primary malignancies in adolescents. However, inconsistent conclusions on the diagnostic performance of various kinds of miRNAs have been made. To assess the true diagnostic value of circulating miRNA for the early detection of OS in this meta-analysis, multiple databases, including PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Technology of Chongqing (VIP), were carefully searched for available studies up to October 30, 2015. The quality of each study was scored using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2). Sensitivity and specificity was pooled using a random-effects model. Positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) were used to measure the diagnostic values. Subgroup and meta-regression analyses were used to find potential sources of heterogeneity. Publication bias was tested with the Deeks’ funnel plot asymmetry test. Eight articles with 741 OS patients and 479 healthy controls were finally included in this meta-analysis. The pooled estimations indicated circulating miRNAs has a high accuracy for diagnosing OS, with sensitivity of 0.94, specificity of 0.80, PLR of 4.75, NLR of 0.07, DOR of 69, and AUC of 0.94. In addition, subgroup and meta-regression analyses revealed that the expression patterns of miRNAs obtained from plasma are more credible diagnostic biomarkers than those from serum. In conclusion, as noninvasive biomarkers, circulating miRNAs have a promising future for the diagnosis of OS in Asian populations.     

Diagnostic value of RASSF1A hypermethylation in colorectal cancer: a meta-analysis

Purpose

Ras association domain family 1 isoform A (RASSF1A), a member of Ras association domain family, plays an important role in tumorigenesis. The goal of our meta-analysis was to assess the diagnostic value of RASSF1A hypermethylation in colorectal cancer (CRC).

Diagnostic accuracy of IL-2 for the diagnosis of latent tuberculosis: a systematic review and meta-analysis

We conducted a systematic review and meta-analysis to evaluate the diagnostic potential of interleukin-2 (IL-2) as biomarkers for the diagnosis of latent tuberculosis. Related studies were identified through searches of PubMed, Embase, Web of Science, and complementary manual searches up to December 30, 2013. We used standard methods recommended for meta-analyses of diagnostic test evaluations. The analysis was based on a summary receiver operating characteristic (SROC) curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of the meta-analysis. The potential presence of publication bias was tested using the Deeks’ funnel plots. The pooled estimates of IL-2 for latent tuberculosis infection (LTBI) diagnosis were as follows: sensitivity, 0.81 [95 % confidence interval (CI), 0.60 to 0.92]; specificity, 0.95 (95 % CI, 0.90 to 0.97); positive likelihood ratio (PLR), 15.2 (95 % CI, 8.1to 28.4); negative likelihood ratio (NLR), 0.20 (95 % CI, 0.09 to 0.47). We found that the SROC curve is positioned near the upper left corner of the curve and the area under the curve (AUC) was 0.96 (95 % CI, 0.94 to 0.98). In conclusion, according to the meta-analysis, IL-2 is a valid marker for the diagnosis of LTBI. When there is no definite gold standard for the diagnosis of LTBI, IL-2 release assay in addition to interferon-gamma release assays (IGRAs) can improve the ability of IGRAs to identify individuals with LTBI.     

Diagnostic value of circRNAs as effective biomarkers in human cardiovascular disease: an updated meta-analysis

Background: A growing body of literature has demonstrated that circular RNAs (circRNAs) are the potential biomarkers in human cardiovascular disease (CVD). Therefore, a meta-analysis based on current studies was accomplished to appraise the role of circRNAs in the diagnostic of CVD patients.Methods: Studies before October 30, 2021, were searched using PubMed, EMBASE, the Web of Science, and Cochrane Library. The diagnostic odds ratio (DOR) with a confidence interval (CI) of 95% was used to investigate the associations between circRNAs and CVDs.Results: A total of 27 eligible articles were selected, including 47 studies, with 6833 participants meeting the criteria standard constrain. The pooled overall sensitivity and specificity for circRNAs expression profile in differentiating CVD patients from controls (non-CVDs or healthy subjects) were 0.81 (95%CI 0.78-0.83) and 0.74 (95%CI 0.68-0.78), respectively; the overall positive likelihood ratio was 3.1 (95%CI 2.5-3.7); the negative likelihood ratio was 0.26 (95%CI 0.22-0.31); the overall diagnostic odds ratio corresponding to an area under the curve of 0.85 (95%CI 0.81-0.88) was 12 (95%CI 9-16). Subgroup analysis indicated that the serum rather than blood has higher diagnostic accuracy. Likewise, meta-regression analysis demonstrated that the specimen, detection method, sample size, and publication year were the main sources of heterogeneity. Sensitivity analysis and Deeks'' funnel plot revealed that our results are relatively robust.Conclusions: Our evidence-based analysis results suggested that circRNAs provide higher diagnostic accuracy in the prediction of CVDs. Thus, circRNAs might be potential biomarkers in CVDs.     

Identification of novel diagnostic biomarkers in endometrial cancer using targeted metabolomic profiling

PurposeEndometrial cancer (EC) is the most common gynecological malignancy with high disease burden especially in advanced stages of the disease. Our study investigated the metabolomic profile of EC patient’s serum with the aim of identifying novel diagnostic biomarkers that could be used especially in early disease detection.Material and methodsUsing targeted metabolomic serum profiling based on HPLC-TQ/MS, women with EC (n ​= ​15) and controls (n ​= ​21) were examined for 232 endogenous metabolites.ResultsTop performing biomarkers included ceramides, acylcarnitines and 1-methyl adenosine. Top 4 biomarkers combined achieved 94% sensitivity with 75% specificity with AUC 92.5% (CI 90.5–94.5%). Individual markers also provided significant predictive values: C16-ceramide achieved sensitivity 73%, specificity 81%, AUC 0.83, C22-ceramide sensitivity 67%, specificity 81%, AUC 0.77, hydroxyhexadecenoylcarnitine sensitivity 60%, specificity 96%, AUC 0.76 and 1-methyladenosine sensitivity 67%, specificity 81%, AUC 0.75. The individual markers, however, did not reach the high sensitivity and specificity of the 4-biomarker combination.ConclusionsUsing mass spectrometry targeted metabolomic profiling, ceramides, acylcarnitines and 1-methyladenosine were identified as potential diagnostic biomarkers for EC. Additionally, these identified metabolites may provide additional insight into cancer cell metabolism.     

血液miRNA作为子宫内膜异位症诊断生物标志物的Meta分析

目的 通过 Meta分析评价血液 miRNA对子宫内膜异位症的诊断价值,确定血液 miRNA作为区分子宫内膜异位症无创性诊断生物标志物。方法 检索中英文数据库从建库至2022年9月关于血液miRNA诊断子宫内膜异位症的相关文献, 提取文献数据,采用Stata14.0软件和RevMan 5.4用于数据分析和质量评估。结果 共纳入了24篇相关文献,血液miRNA作为诊断子宫内膜异位症的总灵敏度为0.86,特异性为0.84,阳性似然比为5.3,阴性似然比为0.17,诊断优势比 (Diagnostic odds Rotio,DOR) 为31,曲线下面积 (Area Under the Curve,AUC) 为0.91,进行元回归及亚组分析,血清、亚洲和非洲人群、异位内膜表达上调的miRNA诊断EMs的准确价值较高。结论 血液miRNA可以作为子宫内膜异位症诊断生物标志物, 血清中表达上调的miRNA在亚洲和非洲人群中诊断子宫内膜异位症 (Endometriosis,EMs) 的诊断价值较高。     

Diagnostic value of survivin for malignant pleural effusion: a clinical study and meta-analysis

Objective: To investigate the diagnostic accuracy of survivin for malignant pleural effusion (MPE). Methods: Pleural effusion samples were collected from 40 MPE patients and 45 non-MPE patients. Pleural levels of survivin were measured by ELISA. Literature search was performed in Pubmed and Embase to identify studies regarding the usefulness of survivin to diagnose MPE. Data were retrieved and the pooled sensitivity, specificity and other diagnostic indexes were calculated. The summary receiver operating characteristics (SROC) curve was used to determine the overall diagnostic accuracy. Results: The pleural levels of survivin were higher in MPE patients than non-MPE patients (844.17 ± 358.30 vs. 508.08 ± 169.58 pg/ml, P < 0.05), at a cut-off value of 683.2 pg/ml, the sensitivity and specificity were 57.50% and 88.89%, respectively. A total of six studies were included in present meta-analysis, the overall diagnostic estimates were: sensitivity 0.74 (95% CI: 0.59-0.85); specificity, 0.85 (95% CI: 0.79-0.89); positive likelihood ratio, 4.79 (95% CI: 3.48-6.61); negative likelihood ratio, 0.31 (95% CI: 0.19-0.50), and diagnostic odds ratio, 15.59 (95% CI: 7.69-31.61). The area under SROC curve was 0.86 (95% CI: 0.82-0.89). Conclusion: Our study confirms that the pleural survivin plays a role in the diagnosis of MPE. More studies at a large scale should be performed to validate our findings.     

What convalescent plasma in treating severe acute respiratory infections of viral aetiology can hint for COVID-19? Evidence from a meta-analysis

ObjectiveTo explore whether convalescent plasma therapy is beneficial to patients with severe acute respiratory infections and gave hints to the management of COVID-19.MethodsA comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane library was conducted for all eligible studies range from inception to February 29, 2020. Studies with control group were included. Treatment group received convalescent plasma therapy, and control group may receive any therapy other than convalescent plasma therapy. Odds ratios (ORs), mean differences (MDs) and 95% confidence intervals (CIs) were pooled for categorical and continuous outcomes.ResultsA total of 1997 patients from 13 studies were included, and seven studies were prospectively designed. Pooled analysis indicated convalescent plasma treatment significantly reduced the mortality by 51% (OR = 0.49, 95% CI: 0.36 to 0.67). Subgroup analyses by publication time, study design, and influenza A revealed similar results. Sensitivity analyses suggested that the results were stable. In addition, convalescent plasma therapy reduced mechanical ventilation requirement (OR: 0.35, 95% CI: 0.21 to 0.59), while it was not associated with less use of extracorporeal membrane oxygenation (OR: 2.0, 95% CI: 0.83 to 4.83) and shorter length of hospital stay (MD: −2.20, 95% CI: −4.98 to 0.57 days). Pooled estimates showed there was no difference in serious adverse effects between the convalescent plasma treatment and control groups (OR: 0.75, 95% CI: 0.50 to 1.13).ConclusionConvalescent plasma therapy significantly reduced the mortality and mechanical ventilation requirements of patients with virus-induced severe acute respiratory infections, without serious adverse effects. More studies are needed to explore whether this treatment can be extrapolated into COVID-19.     

Vancomycin area under the curve to minimum inhibitory concentration ratio predicting clinical outcome: a systematic review and meta-analysis with pooled sensitivity and specificity

BackgroundVancomycin is a first-line antibiotic for methicillin-resistant Staphylococcus aureus infections or other Gram-positive infections. The area under the curve (AUC) to minimum inhibitory concentration (MIC) ratio is proposed as a therapeutic drug-monitoring parameter. How well clinical efficacy is predicted by this measure has not been established.ObjectiveDetermine the test performance characteristics (TPC) of AUC:MIC of vancomycin for prediction of positive outcome.Data SourcesPubMed and Ovid Medline (1946 to 2018) and EMBASE (1974 to 2018).Study Eligibility Criteria and Participants: Studies of patients treated with vancomycin for any type of infection in peer reviewed publications. All patient populations were included.InterventionsVancomycin AUC:MIC or AUC was related to patient clinical outcome.MethodsSearches of medical databases using relevant terms were performed. Screening, study reviewing, data extracting and assessing data quality was performed independently by two reviewers. Studies were stratified by type of primary outcome for calculation of pooled sensitivity, specificity and construction of hierarchical summary receiver operating characteristic (HSROC) curves.ResultsNineteen studies including 1699 patients were meta-analysed. Pooled sensitivity and specificity were 0.77 (95% CI 0.67–0.84) and 0.62 (95% CI 0.53–0.71) respectively for the seven studies with primary outcome of mortality and 0.65 (95% CI 0.53–0.75), 0.58 (95% CI 0.48–0.67) for studies with composite or clinical cure outcome (n = 12). HSROC curves suggested considerable heterogeneity. An additional 11 studies were described but could not be included for meta-analysis because data were not available. The majority of these studies (9/11) failed to demonstrate a relationship between AUC:MIC and positive clinical outcome.ConclusionsVancomycin AUC:MIC performance was modest and inconsistent. Analysis was limited by studies without sufficient data; therefore, meta-analytic results may overestimate TPC values. Given this, as well as the lack of standardization of methods, widespread adoption of AUC:MIC as the preferred vancomycin monitoring parameter may be premature.     

The value of four imaging modalities in diagnosing lymph node involvement in rectal cancer: an overview and adjusted indirect comparison

Several systematic reviews have investigated the accuracy of imaging modalities for lymph node involvement of rectal cancer, but there are considerable differences in conclusions. This overview aimed to assess the methodological and reporting quality of systematic reviews that evaluated the diagnostic value of imaging modalities for lymph node involvement in patients with rectal cancer and to compare the diagnostic value of different modalities for lymph node involvement. The PubMed, EMBASE, Cochrane Library and Chinese Biomedicine Literature were searched to identify relevant systematic reviews. The methodological quality was assessed using the AMSTAR checklist, and the reporting quality was assessed using PRISMA-DTA checklist. The indirect comparison was conducted to compare the accuracy of different imaging modalities. Seven systematic reviews involving 353 primary studies were included. The median (Range) AMSTAR scores were 6.0 (4.0–9.0); the median (Range) PRISMA-DTA scores were 18.0 (11.0–23.0). Sensitivity of MRI [0.69 (95% CI 0.63, 0.77)] was significantly higher than that of ERUS [0.57 (95% CI 0.53, 0.62)]. Specificity of ERUS [0.80 (95% CI 0.77, 0.83)] was significantly higher than that of CT [0.72 (95% CI 0.67, 0.78)]. Positive likelihood ratio of EUS [3.04 (95% CI 2.75, 3.36)] was significantly higher than that of CT [2.21 (95% CI 1.69, 2.90)]. EUS had better diagnostic value than CT and ERUS in the diagnosis of lymph node involvement. Compared with CT and ERUS, MRI was more sensitive. EUS and MRI had comparable diagnostic accuracy, but no modality was proved to be particularly accurate.

     

Diagnostic accuracy of enzyme-linked immunosorbent assays (ELISA) to detect anti-skin autoantibodies in autoimmune blistering skin diseases: A systematic review and meta-analysis

BackgroundSystematic reviews and meta-analysis are essential tools to accurately and reliably summarize evidence, and can be used as a starting point for developing practice guidelines for the diagnosis and treatment of patients.AimTo estimate the diagnostic accuracy of enzyme-linked immunosorbent assays (ELISA) to detect anti-BP180 and anti-desmoglein 3 (Dsg3) autoantibodies in the diagnosis of autoimmune blistering skin diseases.MethodsA Medline search of English written articles, published between 1994 and 2011, reporting data on the sensitivity and specificity of diagnostic tests was conducted using the following search terms: “BP180 autoantibodies”, “Dsg3 autoantibodies”, and “enzyme linked immunosorbent assay”. The selected articles have been evaluated according to the quality of the statistical methods used to calculate diagnostic accuracy (definition of cutoff value, use of ROC curves, and selection of control cases).The meta-analysis was performed using a summary ROC (SROC) curve and a random-effect model to independently combine sensitivity and specificity across studies.ResultsThe search yielded 69 publications on BP180 autoantibodies and 178 on Dsg3 autoantibodies. A total of 30 studies met the inclusion criteria: 17 provided data on the assays to detect autoantibodies to BP180 in a sample of 583 patients with bullous pemphigoid (BP), while 13 studies provided data on the assays to search for anti-Dsg3 autoantibodies in a sample of 1058 patients with pemphigus vulgaris (PV). The 17 studies on BP180 autoantibodies yielded a pooled sensitivity of 0.87 (95% confidence interval (CI) 0.85 to 0.89) and a pooled specificity of 0.98 (CI, 0.98 to 0.99). The area under the curve (AUC) for the SROC curve was 0.988, and the summary diagnostic odds ratio was 374.91 (CI, 249.97 to 562.30).The 13 studies on Dsg3 autoantibodies which met the inclusion criteria, yielded a pooled sensitivity of 0.97 (CI, 0.95 to 0.98), and a pooled specificity of 0.98 (CI, 0.98 to 0.99). The AUC for the SROC curve was 0.995 and the summary diagnostic odds ratio was 1466.11 (95% CI, 750.36 to 2864.61).ConclusionsResults of the meta-analysis demonstrated that ELISA tests for anti-BP180 and anti-Dsg3 autoantibodies have high sensitivity and specificity for BP and PV, respectively, and can be used in daily laboratory practice for the initial diagnosis of autoimmune blistering skin diseases.     

Serum microRNA-21 as a potential diagnostic biomarker for breast cancer: a systematic review and meta-analysis

Serum microRNA-21 (miR-21) expression has been shown to be significantly up-regulated in breast cancer, which implies that it could be a biomarker to discriminate breast cancer patients from healthy controls. We therefore performed this meta-analysis to assess the diagnostic value of miR-21 for breast cancer. Relevant articles were collected from PubMed, Scopus, Embase, the Cochrane Library, BioMed Central, ISI Web of Knowledge, China National Knowledge Infrastructure, Wan Fang Data and Technology of Chongqing databases, from inception to June 10, 2014 by two independent researchers. Diagnostic capacity of miR-21 for breast cancer was assessed using pooled sensitivity and specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (AUC) and Fagan’s nomogram. Meta-Disc software and Stata SE 12.0 were used to investigate the source of heterogeneity and to perform the meta-analysis. We used six studies with a total of 438 patients and 228 healthy controls in this meta-analysis. The pooled sensitivity, specificity and DOR were 0.79 [95 % confidence interval (CI) 0.66–0.87], 0.85 (95 % CI 0.75–0.91) and 19.46 (95 % CI 8.74–43.30), respectively; positive and negative likelihood ratios were 5 and 0.25, and AUC was 0.89 (95 % CI 0.86–0.91). In addition, heterogeneity was clearly apparent but was not caused by the threshold effect. This meta-analysis suggests that miR-21 is a potential biomarker for early diagnosis of breast cancer with high sensitivity and specificity, and its clinical application warrants further investigation.     

Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis: an updated meta-analysis

The objective of this investigation was to systematically evaluate the diagnostic accuracy of interferon-gamma release assays (IGRAs) for tuberculosis disease. Both English and Chinese databases were searched for relevant articles through January 2012. We included studies that were restricted to diagnostic applications of IGRAs in patients with active tuberculosis and excluded studies performed in the immune-compromised population. We used Meta-DiSc software to handle the data. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and 95?% confidence interval (CI) for each study. We also calculated the pooled sensitivity, specificity, PLR, NLR, DOR, and produced forest plots and summary receiver operating characteristic (SROC) curves. A total of 61 papers (73 studies) were eligible for meta-analysis, including 36 published in English and 25 published in the Chinese language. The overall sensitivity, specificity, PLR, NLR, DOR, and 95?% CI of IGRAs were 0.85 (95?% CI: 0.84–0.86), 0.84 (95?% CI: 0.83–0.85), 7.82 (95?% CI: 6.01–10.19), 0.17 (95?% CI: 0.14–0.21), and 59.27 (95?% CI: 40.19–87.42), respectively. For ten studies evaluating T-SPOT.TB in China, the combined sensitivity, specificity, PLR, NLR, DOR, and 95?% CI were 0.88 (95?% CI: 0.86–0.91), 0.89 (95?% CI: 0.86–0.92), 8.86 (95?% CI: 5.42–14.46), 0.13 (95?% CI: 0.10–0.17), and 88.15 (95?% CI: 41.76–186.07), respectively. The SROC area under the curve (AUC) was 0.9548 (95?% CI: 0.9323–0.9773). Though IGRAs showed good sensitivity and specificity for the detection of tuberculosis in this meta-analysis, the decision to use an IGRA should be based on the local prevalence of the disease and the country guidelines, as well as resources and logistical considerations.     

Diagnostic performance of Body Mass Index,Waist Circumference and the Waist-to-Height Ratio for identifying cardiometabolic risk in Scottish pre-adolescents

Background: Limited studies have examined the diagnostic performance of body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR) for identifying cardiometabolic risk (increased clustered glucose, triglycerides, mean arterial pressure and inv-HDL-cholesterol) in pre-adolescent youth.

Aim: To compare the utility of BMI, WC and WHtR as predictors of cardiometabolic risk (CMR) in Scottish pre-adolescent children.

Subjects and methods: A cross-sectional analysis of 223 Scottish children (55.2% boys, mean age =8.4 years) was undertaken. BMI, WC and WHtR were used as exposure variables within multivariate logistic regression analysis and ROC analysis to examine the utility of these anthropometrical indices in identifying those at cardiometabolic risk.

Results: Individuals with an elevated WHtR, WC and BMI were 3.51 (95% CI?=?1.71–7.23; p?p =?.002) and 2.59 (95% CI?=?1.42–4.73; p?=?.002) times more likely to be at cardiometabolic risk, respectively. The areas under the curves [AUC] to identify children with cardiometabolic risk were significant and similar among anthropometric indices (AUC’s?=?0.60–0.65). When stratified by BMI, both WC and WHtR demonstrated a fair-to-good ability for identifying those at cardiometabolic risk (AUC?=?0.75–0.81).

Conclusions: Findings suggest that the combination of BMI with either WC or WHtR may provide an added benefit in the assessment of cardiometabolic risk amongst pre-adolescents.     

The diagnostic and prognostic significance of long noncoding RNAs expression in thyroid cancer: A systematic review and meta-analysis

Objective

Thyroid cancer (TC) is the most common malignant endocrine-related cancer with an increasing trend worldwide. Therefore, it’s in urgent need to find new markers for prognosis and diagnosis. Many long noncoding RNAs (lncRNAs) have been reported to be aberrantly expressed in TC, and may serve as biomarkers. Therefore, we performed this meta-analysis to systematically summarize the relationship between lncRNA expressions and TC.