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Meta-Analysis
. 2022 Sep 10:2022:7078652.
doi: 10.1155/2022/7078652. eCollection 2022.

The Value of Adenosine Deaminase 2 in the Detection of Tuberculous Pleural Effusion: A Meta-Analysis and Systematic Review

Tingting Zeng  1 , Bing Ling  1 , Xueru Hu  1 , Shuyan Wang  1 , Wenliang Qiao  2 , Lijuan Gao  1 , Yongchun Shen  1 , Dajiang Li  3
Affiliations
Meta-Analysis

The Value of Adenosine Deaminase 2 in the Detection of Tuberculous Pleural Effusion: A Meta-Analysis and Systematic Review

Tingting Zeng et al. Can Respir J. .

Abstract

Adenosine deaminase 2 (ADA2) is reported as a novel diagnostic biomarker for tuberculous pleural effusion (TPE) in many studies. This meta-analysis was conducted to systematically evaluate the general diagnostic performance of pleural ADA2 in TPE. After searching for relevant studies that investigated the diagnostic performance of pleural ADA2 in TPE in several databases, we assessed and selected eligible studies to calculate pooled parameters by STATA 16.0 software. A final set of thirteen studies entirely met the inclusion standards and were used to calculate pooled parameters in our meta-analysis. Among them, there were nine English studies and four Chinese studies. The pooled parameters of pleural ADA2 in diagnosing TPE were summarized as follows: sensitivity, 0.91 (95% CI: 0.86-0.95); specificity, 0.93 (95% CI: 0.92-0.95); positive likelihood ratio, 13.9 (95% CI: 10.6-18.3); negative likelihood ratio, 0.09 (95% CI:0.06-0.16); diagnostic odds ratio, 147 (95% CI: 76-284); and the area under the curve, 0.95 (95% CI: 0.93-0.97). Pleural ADA2 is a reliable indicator with excellent accuracy in TPE diagnosis. However, we need to combine pleural ADA2 with diverse examinations to diagnose TPE in clinical practice.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the selection process.
Figure 2
Figure 2
Summary of QUADAS-2 assessments of the included studies. QUADAS-2, Quality Assessment of Diagnostic Accuracy Studies-2. Four fields included are the patient selection methods, index test, reference standard, and flow and timing.
Figure 3
Figure 3
Forest plots of sensitivity and specificity for ADA2. The pooled sensitivity was 0.91 (95% CI: 0.86–0.95), and the pooled specificity was 0.93 (95% CI: 0.92–0.95).
Figure 4
Figure 4
The summary receiver operating characteristic (SROC) curve and the area under the curve (AUC). The AUC was 0.95 (95% CI: 0.93–0.97). AUC, area under the curve; SENS, sensitivity; SPEC, specificity.
Figure 5
Figure 5
Fagan's nomogram.
Figure 6
Figure 6
Meta-regression of the included studies. Both sensitivity and specificity were significantly affected by publication year and the cutoff value (P < 0.05), indicating that publication year, cutoff value, and other unknown covariates result in heterogeneity.
Figure 7
Figure 7
Deeks's funnel plot. The apparent asymmetric shape of Deeks's funnel plot and P value = 0.02 indicate that publication bias significantly existed in the study.
See this image and copyright information in PMC

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