miRNA区分活动性结核和潜伏性结核的Meta分析  

Meta-analysis of miRNA in discriminating active tuberculosis and latent tuberculosis

作　　者：李晓颖 肖江明 廖璞 LI Xiaoying;XIAO Jiangming;LIAO Pu(Department of Clinical Laboratory,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Clinical Laboratory,Chongqing People′s Hospital,Chongqing 400010,China)

机构地区：[1]西南医科大学附属医院检验科,四川泸州646000 [2]重庆市人民医院检验科,重庆400010

出　　处：《国际检验医学杂志》2024年第4期500-504,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨微小RNA(miRNA)区分活动性结核和潜伏性结核的Meta分析。方法检索中国知网、万方数据、维普、PubMed、Cochrane Library、Web of Science和Embase数据库,选取从建库至2023年4月有关miRNA区分活动性结核和潜伏性结核的文献,并严格按照纳入和排除标准进行筛选。采用诊断准确性研究质量评估量表评估纳入研究的质量,以及Stata16.0软件进行数据提取和汇总分析。通过计算I^(2)对研究间的异质性进行评估,并通过Meta回归和亚组分析进一步分析异质性来源。采用Deeks漏斗图评估发表偏倚。结果共纳入涉及13项研究的9篇文献。Meta分析结果显示,miRNA在区分活动性结核和潜伏性结核病的合并灵敏度为0.79(95%CI:0.69~0.86,I^(2)=86.24%),特异度为0.73(95%CI:0.64~0.81,I^(2)=81.80%),阳性似然比为2.96(95%CI:2.22~3.95,I^(2)=63.84%),阴性似然比为0.29(95%CI:0.20~0.41,I^(2)=84.04%),诊断比值比为10.33(95%CI:6.43~16.61,I^(2)=99.90%),受试者工作特征曲线的曲线下面积为0.83(95%CI:0.79~0.86)。Meta回归和亚组分析结果显示,样本量可能是导致灵敏度异质性的来源,miRNA的失调状态可能是导致特异度异质性的来源。Deeks漏斗图显示研究间不存在发表偏倚。结论miRNA在区分活动性结核和潜伏性结核病方面表现出良好的诊断能力,为改进结核病管理诊断策略的发展具有重要的意义。Objective To investigate the Meta-analysis of microRNA(miRNA)in distinguishing active tuberculosis and latent tuberculosis.Methods CNKI,Wanfang Data,VIP,PubMed,Cochrane Library,Web of Science and Embase databases were searched to select the literature on miRNA in discriminating active tuberculosis and latent tuberculosis from the establishment of the database to April 2023,and screened strictly according to the inclusion and exclusion criteria.The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2,and data extraction and summary analysis were carried out with Stata16.0 software.Heterogeneity among studies was evaluated by calculating I^(2),and the sources of heterogeneity were further explored by Meta-regression and subgroup analysis.Publication bias was assessed using Deeks funnel plot.Results The Meta-analysis encompassed 9 articles,comprising 13 studies.The combined sensitivity of miRNA in differentiating active tuberculosis and latent tuberculosis was found to be 0.79(95%CI:0.69-0.86,I^(2)=86.24%),with a specificity of 0.73(95%CI:0.64-0.81,I^(2)=81.80%).The positive likelihood ratio was 2.96(95%CI:2.22-3.95,I^(2)=63.84%),while the negative likelihood ratio was 0.29(95%CI:0.20-0.41,I^(2)=84.04%).Furthermore,the diagnostic odds ratio was 10.33(95%CI:6.43-16.61,I^(2)=99.90%),and the area under the receiver operating characteristic curve was 0.83(95%CI:0.79-0.86).The results of Meta-regression and subgroup analysis showed that sample size may be the source of sensitivity heterogeneity,and dysregulation of miRNA may be the source of specificity heterogeneity.Deeks funnel plot showed no publication bias among included studies.Conclusion miRNA shows good diagnostic ability in distinguishing active tuberculosis and latent tuberculosis,which has important significance for improving the development of diagnostic strategies for tuberculosis management.

关 键 词：活动性结核 潜伏性结核 微小RNA META分析 

分 类 号：R446.1[医药卫生—诊断学]