Diagnostic Value of T-SPOT.TB Assay for Tuberculous Peritonitis: A Meta-Analysis

Frontiers in Medicine

article

Ying Luo¹  Ying Xue²  Liyan Mao¹  Qun Lin¹  Guoxing Tang¹  Huijuan Song¹  Feng Wang¹  Ziyong Sun¹ 

[1] Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology

关键词: tuberculous peritonitis;    T-SPOT.TB assay;    diagnosis;    Mycobacterium tuberculosis;    peripheral blood;    peritoneal fluid;   

DOI  :  10.3389/fmed.2020.585180

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Tuberculous peritonitis (TP) is a common form of abdominal tuberculosis (TB). Diagnosing TP remains challenging in clinical practice. The aim of the present meta-analysis was to evaluate the diagnostic accuracy of peripheral blood (PB) T-SPOT and peritoneal fluid (PF) T-SPOT for diagnosing TP. Methods: PubMed, EmBase, Cochrane, Scopus, Google scholar, China national knowledge internet, and Wan-Fang databases were searched for relevant articles from August 1, 2005 to July 5, 2020. Statistical analysis was performed using Stata, Revman, and Meta-Disc software. Diagnostic parameters including pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were determined. Summary receiver operating characteristic curve was used to determine the area under the curve (AUC). Results: Twelve studies were eligible and included in the meta-analysis. The analysis showed that the pooled sensitivity and specificity of PB T-SPOT in diagnosing TP were 0.91 (95% CI, 0.88–0.94) and 0.78 (95% CI, 0.73–0.81), respectively, while the pooled PLR, NLR, and DOR were 4.05 (95% CI, 2.73–6.01), 0.13 (95% CI, 0.07–0.23), and 37.8 (95% CI, 15.04–94.98), respectively. On the other hand, the summary estimates of sensitivity, specificity, PLR, NLR, and DOR of PF T-SPOT for TP diagnosis were 0.90 (95% CI, 0.85–0.94), 0.78 (95% CI, 0.72–0.83), 6.35 (95% CI, 2.67–15.07), 0.14 (95% CI, 0.09–0.21), and 58.22 (95% CI, 28.76–117.83), respectively. Furthermore, the AUC of PB T-SPOT and PF T-SPOT for TP diagnosis were 0.91 and 0.94, respectively. Conclusions: Our results indicate that both PB T-SPOT and PF T-SPOT can be served as sensitive approaches for the diagnosis of TP. However, the unsatisfactory specificities of these two methods limit their application as rule-in tests for TP diagnosis. Furthermore, the standardization of the operating procedure of PF T-SPOT is further needed.

【 授权许可】

CC BY