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. 2017 Apr 12:5:e3136.
doi: 10.7717/peerj.3136. eCollection 2017.

Performance of interferon- γ release assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Qianqian Liu #  1   2 , Wenzhang Li #  3 , Yunfeng Chen  1 , Xinmiao Du  2 , Chengdi Wang  2 , Binmiao Liang  2 , Yin Tang  4   5 , Yulin Feng  2 , Chuanmin Tao  6 , Jian-Qing He  2
Affiliations

Performance of interferon- γ release assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Qianqian Liu et al. PeerJ. .

Abstract

Background: The diagnostic values of interferon-gamma release assays (IGRA) in tuberculosis (TB) vary a lot with different site of infections, with especially higher sensitivities in chronic forms of TB such as tuberculosis of the lymph node. We conducted a meta-analysis to comprehensively evaluate the overall accuracy of diagnostic IGRA for tuberculous lymphadenitis.

Methods: Pubmed, Web of Science, EMBASE, Wanfang and CNKI databases up to February 17, 2017 were searched to identify published studies. The study quality was evaluated using the QUADAS-2 checklist. The pooled estimates of diagnostic parameters were generated using a bivariate random-effects model and summary receiver operating characteristic (SROC) curves were used to summarize global performance.

Results: A total of ten qualified studies, performed in Korea or China, including 1,084 patients, were enrolled in this meta-analysis. The pooled estimates of diagnostic accuracy were as follows: sensitivity, 0.89 (95% CI [0.85-0.92]); specificity, 0.81 (95% CI [0.77-0.83]); positive likelihood ratio (PLR), 4.25 (95% CI [2.79-6.47]); negative likelihood ratio (NLR), 0.16 (95% CI [0.12-0.22]); and area under the curve (AUC) was 0.93. According to subgroup analyses, studies conducted using QuantiFERON-TB, in Korean population and focusing on cervical lymphadenitis exhibited relative higher specificity while lower sensitivity. No evidence of publication bias was identified.

Conclusions: IGRA exhibits high diagnostic accuracy in tuberculous lymphadenitis. The diagnostic value of IGRA differed by different IGRA methods, ethnicity and lymphadenitis location. Our conclusion may be more applicable to population from TB prevalent areas.

Keywords: Diagnosis; Interferon-gamma release assay; Meta-analysis; Tuberculous lymphadenitis.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Flow diagram of included studies.
Figure 2
Figure 2. Forest plot evaluating the sensitivity and specificity of diagnostic performance of IGRA in tuberculous lymphadenitis.
CI, confidence interval. (A) Sensivitity; (B) Specificity.
Figure 3
Figure 3. Summary receiver operator characteristics (SROC) of IGRA on summary estimates of sensitivity and specificity.
AUC, area under the curve; SE, standard error
Figure 4
Figure 4. Deeks’ funnel plots for publication bias.
See this image and copyright information in PMC

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