Body Fluid Interferon-γ Release Assay for Diagnosis of Extrapulmonary Tuberculosis in Adults: A Systematic Review and Meta-Analysis.
The diagnosis of extrapulmonary tuberculosis (EPTB) is difficult. In recent years, T-cell interferon-γ release assays (IGRAs) are widely used in diagnosing tuberculosis. The aim of this meta-analysis is to evaluate the diagnostic accuracy of body fluid IGRAs in diagnosing EPTB. The PubMed, EMBASE, Web of Science, and Cochrane bibliographies were searched for English language articles. 22 studies met the inclusion criteria. The pooled sensitivity and specificity of body fluid IGRAs for diagnosing EPTB were 0.87 [95% confidence interval (CI): 0.83-0.92] and 0.85 (95% CI: 0.79-0.90), respectively. For the fluid T-SPOT.TB, the pooled sensitivity and specificity were 0.92 (95% CI: 0.88-0.95) and 0.85 (95% CI: 0.78-0.91), respectively. The diagnostic odds ratio (DOR) of the fluid T-SPOT.TB was 46.99 (95% CI: 13.69-161.28) for tuberculosis pleurisy, 26.46 (95% CI: 11.38-61.56) for tuberculosis peritonitis, and 97.86 (95% CI: 25.31-378.45) for tuberculosis meningitis. The application of T-SPOT. TB in the diagnosis of EPTB performed better in the body fluid than in the blood. The diagnostic values of the fluid T-SPOT.TB varied for different fluid categories. However, the utility of T-SPOT.TB was limited due to its suboptimal accuracy and higher cost compared with conventional tests.
Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.|Geriatric Department, Fu Xing hospital, Capital Medical University, Beijing, China.
Xiao-Xia
XX
Zhou
Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Ya-Lan
YL
Liu
Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Kan
K
Zhai
Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.|Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Huan-Zhong
HZ
Shi
Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.|Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Zhao-Hui
ZH
Tong
D001826:Body Fluids / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D014376:Tuberculosis / Q000175:diagnosis*
D007371:Interferon-gamma