title: Performance of polymerase chain reaction techniques detecting granzyme B in the diagnosis of acute renal rejection: a meta-analysis.
abstract: BACKGROUND
  Studies have shown that granzyme B expression was up-regulated during acute renal rejection, which provides hopes for a noninvasive and reliable diagnostic method. However, the diagnostic performance has not been assessed systematically so far.
  
  
  METHODS
  Relevant materials were searched from electronic databases before February 1, 2012. Clinical studies that reported the diagnostic performance of detecting granzyme B mRNA using polymerase chain reaction techniques in acute renal rejection patients were included. The data of true-positive, true-negative, false-positive, and false-negative cases identified by granzyme B detection were extracted from each data set of the relevant materials. The publication year, sample origin, mRNA quantification method, and housekeeping gene were extracted as potential confounding variables.
  
  
  RESULTS
  Fourteen studies with a total of 514 cases were included. The overall diagnostic performance of granzyme B was pooled sensitivity of 0.76 (95% confidence interval [CI], 0.69-0.81), pooled specificity of 0.87 (95% CI, 0.83-0.90), diagnostic odds ratio of 19.27 (95% CI, 1.20-195.00), and area under the summary receiver operating characteristic curve value of 0.8900±0.0270. The univariate analysis of potential variables showed no statistically significant variations.
  
  
  CONCLUSIONS
  Despite interstudy variability, granzyme B mRNA demonstrated both sensitivity and specificity in the diagnosis of acute rejection and showed consistency under circumstances of methodologic changes. However, the clinical practice requires careful consideration and other supplementary tests.
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
authors.forename: Yushu
authors.initials: Y
authors.lastname: Shang
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Ju
authors.forename: Yuan
authors.initials: Y
authors.lastname: Kong
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Ling
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
mesh_terms: D000208:Acute Disease; D006084:Graft Rejection / Q000175:diagnosis*; D053804:Granzymes / Q000032:analysis / Q000235:genetics*; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods; D012333:RNA, Messenger / Q000032:analysis
chemical_list: D012333:RNA, Messenger; D053804:Granzymes