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. 2018 Sep 8:13:329-337.
doi: 10.1515/med-2018-0050. eCollection 2018.

Diagnostic Efficacy of Serum 1,3-β-D-glucan for Invasive Fungal Infection: An Update Meta-Analysis Based on 37 Case Or Cohort Studies

Lu Xiaoling  1 , Tang Tingyu  1 , Hu Caibao  2 , Zhao Tian  1 , Chen Changqin  3
Affiliations

Diagnostic Efficacy of Serum 1,3-β-D-glucan for Invasive Fungal Infection: An Update Meta-Analysis Based on 37 Case Or Cohort Studies

Lu Xiaoling et al. Open Med (Wars). .

Abstract

Objective: The aim of this study was to investigate the diagnostic performance of serum 1,3-β-D-gluan as biomarker for invasive fungal infection through meta-analysis.

Methods: The electronic databases of Medline, Cochrane, Embase, Web of Science, OVID and CNKI were systematic searched to identified the case-control or Cohort studies relevant to diagnostic efficacy of serum 1,3-β-D-glucan for invasive fungal infection. The data of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) patients number were extracted from each of the original included studies. The diagnostic sensitivity, specificity and systematic receiver operating characteristic (SROC) curve were calculated and pooled through random or fixed effect method. The publication bias was evaluated by the Deek's funnel plot.

Results: Thirty-seven relevant studies were fulfilled the inclusion criteria and included in our present meta-analysis. The combined sensitivity, specificity, positive likely hood ratio (+lr), negative likely hood ratio (-lr) and diagnostic odds ratio(dor) for 1,3-β-D-glucan in diagnosis of invasive fungal infectionwere 0.83 (95%CI:0.38-0.61), 0.81 (95%CI:0.80-0.82), 5.13 (95%CI:3.98-6.62), 0.23 (95%CI:0.18-0.30), and 29.68 (95%CI:18.94-46.52) respectively. The pooled area under the ROC curve (AUC) was 0.91.The Deek's funnel plot asymmetry test showed there was no publication bias for 1,3-β-D-glucan in diagnosis of invasive fungal infection of the included 37 studies.

Conclusion: Serum 1,3-β-D-glucan assay was a promising biomarker for invasive fungal infection diagnosis.

Keywords: 1,3-β-D-glucan; diagnosis; invasive fungal infection; meta-analysis.

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Conflict of interest statement

Conflict of interest: The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The flowchart of publication searching and studies inclusion
Figure 2
Figure 2
The general quality of the included 37 studies evaluated by QUADAS
Figure 3
Figure 3
Pooled forest plot of sensitivity of 1,3-β-D-glucan in diagnosis of invasive fungal infection.
Figure 4
Figure 4
Pooled forest plot of specificity of 1,3-β-D-glucan in diagnosis of invasive fungal infection
Figure 5
Figure 5
Pooled forest plot of +lr for 1,3-β-D-glucan in diagnosis of invasive fungal infection
Figure 6
Figure 6
Pooled forest plot of -lr for 1,3-β-D-glucan in diagnosis of invasive fungal infection
Figure 7
Figure 7
Pooled forest plot of dor for 1,3-β-D-glucan in diagnosis of invasive fungal infection
Figure 8
Figure 8
The AUC of the SROC for 1,3-β-D-glucan in diagnosis of invasive fungal infection
Figure 9
Figure 9
The scatter plot of diagnostic efficacy changes according to cutoff value
Figure 10
Figure 10
The funnel plot of publication bias for 1,3-β-D-glucan in diagnosis of invasive fungal infection
See this image and copyright information in PMC

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