循环微小RNA对活动性结核病诊断效能的荟萃分析

目的用荟萃(meta)分析评价循环微小RNA对活动性结核病的诊断效能。方法检索PubMed、Web of Science、Embase、中国知网、万方、维普及中国生物医学文献数据库(CBM)等数据库收集文献,检索时限均为从建库至2019年4月。并根据文献中的原始资料评价循环miRNA检测活动性结核病的准确性,采用Stata 15.0软件进行meta分析。结果共纳入21篇文献,累计1142例患者和1231例对照者。meta分析结果显示合并敏感性为0.85(95%CI:0.78~0.89)、特异性为0.85(95%CI:0.81~0.88)、阳性似然比为5.49(95%CI:4.21~7.15)、阴性似然比为0.18(95%CI:0.13~0.26)、合并诊断比值比为30.06(95%CI:16.88~53.52),SROC曲线下面积(AUC)为0.91(95%CI:0.88~0.93)。亚组分析显示,miRNA-155用于诊断活动性结核病的AUC为0.90(95%CI:0.87~0.92)。结论循环miRNA是诊断活动性结核病的重要生物标志物,有较高敏感性和特异性。

Diagnostic performance of circulating miRNA for active tuberculosis: a meta-analysis

Objective To evaluate the diagnostic performance of circulating miRNAs for active tuberculosis by meta-analysis.Methods The databases PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,CQVIP and China Biology Medicine(CBM)were searched from inception of April,2019 to collect the studies on circulating miRNA as biomarkers for the diagnosis of active tuberculosis.The diagnostic accuracy of circulating miRNA for active tuberculosis was assessed based on original data in the retrieved literatures.The meta-analysis was performed by using Stata 15.0 software.Results We retrieved 21 eligible studies involving 1142 patients with active tuberculosis and 1231 controls.The pooled sensitivity,specificity,positive likelihood ratio(LR),negative LR were 0.85(95%CI:0.78 to 0.89),0.85(95%CI:0.81 to 0.88),5.49(95%CI:4.21 to 7.15),0.18(95%CI:0.13 to 0.26),respectively.The pool diagnostic odds ratio was 30.06(95%CI:16.88 to 53.52)and the area under the SROC curve was 0.91(95%CI:0.88 to 0.93).The analyses for subgroup showed the test of miRNA-155 yielded AUC of 0.90(95%CI:0.87 to 0.92)in confirming active tuberculosis.Conclusion The circulating miRNAs should be a significant biochemical marker for the diagnosis of active tuberculosis with high sensitivity and specificity.