Diagnostic value of pentraxin 3 in respiratory tract infections: A meta-analysis

Abstract

Background: Pentraxin 3 is an acute inflammatory protein of the long pentraxin subfamily. A meta-analysis was performed to assess diagnostic accuracy of pentraxin 3 for respiratory tract infections.

Methods: We identify studies examining diagnostic value of pentraxin 3 for respiratory tract infections by searching Pubmed, Web of Knowledge, and Cochrane Library. The sensitivity, specificity, negative likelihood ratio (LR), positive LR, and diagnostic odds ratio were pooled. The area under the summary receiver operator characteristic (SROC) curve and Q point value (Q*) were calculated.

Results: A total of 8 studies with 961 individuals were eligible for this meta-analysis. The pooled sensitivity of pentraxin 3 in diagnosis of respiratory tract infections was 0.78, the pooled specificity was 0.73, the area under the SROC curve was 0.84, and the Q* was 0.77. The area under the SROC curve of serum and bronchoalveolar lavage fluid (BALF) pentraxin 3 was 0.85 and 0.89, respectively. Meta-regression analysis revealed that cutoff value was the source of heterogeneity among the included studies. The Deek funnel plot test suggested no evidence of publication bias. Subgroup analyses showed that the area under the SROC curve of pentraxin 3 in diagnosis of ventilator-associated pneumonia (VAP) was 0.89.

Conclusion: Pentraxin 3 has a moderate accuracy for diagnosing respiratory tract infections and VAP. The overall diagnostic value of BALF level of pentraxin 3 is superior to its serum concentration.

Figure 1

Flowchart of the study selection process.

Figure 2

Forest plot of sensitivity and specificity for pentraxin 3 in diagnosis of respiratory tract infections. The pooled sensitivity was 0.78 (95% CI, 0.74–0.82) and the pooled specificity was 0.73 (95% CI, 0.70–0.77).

Figure 3

Summary receiver operating characteristic (SROC) curve of pentraxin 3 in diagnosis of respiratory tract infections. The area under the SROC curve was 0.84 and the Q^∗ was 0.77.

Figure 4

The Deek funnel plot for assessment of publication bias. No publication bias was found among the included studies.

Figure 5

Forest plot of sensitivity and specificity for pentraxin 3 in diagnosis of ventilator-associated pneumonia (VAP). The pooled sensitivity was 0.77 (95% CI, 0.70–0.83) and the pooled specificity was 0.80 (95% CI, 0.73–0.86).

Figure 6

Forest plot of sensitivity and specificity for pentraxin 3 in diagnosis of bacterial respiratory tract infections. The pooled sensitivity was 0.77 (95% CI, 0.71–0.83) and the pooled specificity was 0.72 (95% CI, 0.65–0.78).

Figure 7

Forest plot of sensitivity and specificity for serum pentraxin 3 in diagnosis of respiratory tract infections. The pooled sensitivity was 0.77 (95% CI, 0.71–0.82) and the pooled specificity 0.75 (95% CI, 0.70–0.79).

Figure 8

Forest plot of sensitivity and specificity for BALF pentraxin 3 in diagnosis of respiratory tract infections. The pooled sensitivity was 0.85 (95% CI, 0.78–0.90) and the pooled specificity was 0.80 (95% CI, 0.76–0.84).