应用TRECs筛查新生儿严重联合免疫缺陷的Meta分析  

Diagnostic accuracy of TRECs in newborn screening for severe combined immunodeficiency:a meta-analysis

作　　者：唐亮 潘梦文 崔其亮[1] 吴繁[1] TANG Liang;PAN Mengwen;CUI Qiliang;WU Fan(Department of Neonatology,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,P.R.China)

机构地区：[1]广州医科大学附属第三医院新生儿科,广州510150

出　　处：《中国循证医学杂志》2023年第6期665-671,共7页Chinese Journal of Evidence-based Medicine

基　　金：广东省自然科学基金项目(编号:2021A1515011225)。

摘　　要：目的系统评价T细胞受体删除环(TRECs)筛查新生儿严重联合免疫缺陷病(SCID)的诊断准确性。方法计算机检索PubMed、EMbase、Cochrane Library、Web of Science、CBM、WanFang Data和CNKI数据库,搜集与研究目的相关的诊断准确性研究,检索时限均从建库至2022年10月26日。由2位研究员独立筛选文献、提取资料并采用QUADAS-2工具评价纳入研究的偏倚风险后,采用Stata 15.0和Meta Disc 1.4软件进行Meta分析。结果共纳入18个研究,包括6243718例新生儿。Meta分析结果显示:TRECs筛查新生儿SCID合并的敏感度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)和诊断比值比(DOR)分别为0.97[95%CI(0.92,0.99)]、1.00[95%CI(1.00,1.00)]、1447.05[95%CI(528.49,3962.11)]、0.13[95%CI(0.08,0.22)]和11698.21[95%CI(2853.44,47958.98)],综合受试者工作特征(SROC)曲线下面积为0.97。结论应用TRECs筛查新生儿SCID的准确性较高,有助于早发现和治疗SCID患儿。受纳入研究的数量和质量限制,上述结论尚待更多高质量研究予以验证。Objective To systematically review the accuracy of T-cell receptor excision circles(TRECs)in screening newborns for severe combined immunodeficiency(SCID).Methods The PubMed,EMbase,Cochrane Library,Web of Science,CBM,WanFang Data and CNKI databases were electronically searched to collect the diagnostic accuracy studies related to the objects from inception to October 26,2022.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies using the QUADAS-2 scale.Meta-analysis was performed using Stata 15.0 and Meta-Disc 1.4 software.Results A total of 18 studies involving 6243718 neonates were included.The results of meta-analysis showed that the pooled sensitivity(SEN),specificity(SPE),positive likelihood ratio(PLR),negative likelihood ratio(NLR),and diagnosis odds ratio(DOR)were 0.97(95%CI 0.92 to 0.99),1.00(95%CI 1.00 to 1.00),1447.05(95%CI 528.49 to 3962.11),0.13(95%CI 0.08 to 0.22)and 11698.21(95%CI 2853.44 to 47958.98),respectively.The area under the summary receiver operating characteristic curve(SROC)was 0.97.Conclusion The application of TRECs in screening neonatal SCID has high accuracy,which is helpful for early diagnosis of SCID.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

关 键 词：严重联合免疫缺陷病 TRECS 新生儿筛查 META分析 系统评价 

分 类 号：R722.1[医药卫生—儿科]