title: Diagnostic value of the soluble triggering receptor expressed on myeloid cells-1 in lower respiratory tract infections: a meta-analysis.
abstract: The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a promising diagnostic marker for many types of infections. A bivariate meta-analysis was performed to evaluate its diagnostic value for lower respiratory tract infections (LRTI). We searched PubMed, Cochrane Library and Web of Science (from January 1966 to August 2013) for all trials assessing diagnostic value of sTREM-1 for LRTI. The pooled sensitivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), diagnostic odds ratio (DOR), the area under summary receiver operator characteristic (SROC) curve and the Q* were calculated. Thirteen studies with 1138 patients were included in our meta-analysis. The pooled sensitivity and specificity of sTREM-1 for diagnosis of LRTI was 0.84 and 0.77. The PLR, NLR and DOR were 3.6, 0.21 and 17. The area under SROC curve was 0.88 and the Q* was 0.82. The univariate meta-regression analysis demonstrated that the assay method for sTREM-1 significantly affected sensitivity for LRTI. The Q* of sTREM-1 for diagnosis of community-acquired LRTI was 0.82, and the area under SROC curve was 0.88. The Q* of sTREM-1 in diagnosis of hospital-acquired LRTI was 0.83, and the area under SROC curve was 0.90. The Q* of sTREM-1 for distinguishing culture-positive LRTI from culture-negative diseases was 0.79, and the area under SROC curve was 0.86. Current evidence suggests that sTREM-1 is an accurate marker of LRTI. The overall diagnostic value of sTREM-1 for LRTI, community-acquired LRTI and hospital-acquired LRTI is similar.
authors.affiliation: Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Ye
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Hu
authors.forename: Ruifeng
authors.initials: R
authors.lastname: Zhang
authors.forename: Kejing
authors.initials: K
authors.lastname: Ying
mesh_terms: D015415:Biomarkers / Q000032:analysis; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000276:immunology; D003428:Cross Infection / Q000175:diagnosis / Q000276:immunology; D003937:Diagnosis, Differential; D006801:Humans; D008562:Membrane Glycoproteins / Q000032:analysis / Q000276:immunology; D022423:Myeloid Cells / Q000276:immunology*; D012372:ROC Curve; D011971:Receptors, Immunologic / Q000032:analysis / Q000276:immunology; D015203:Reproducibility of Results; D012141:Respiratory Tract Infections / Q000145:classification / Q000175:diagnosis / Q000276:immunology; D012680:Sensitivity and Specificity; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
keywords: diagnosis; diagnostic test; lower respiratory tract infection; meta-analysis; soluble triggering receptor expressed on myeloid cells-1