title: Diagnostic Performance of Bronchoalveolar Lavage Fluid CD4/CD8 Ratio for Sarcoidosis: A Meta-analysis.
abstract: BACKGROUND
  The usefulness of bronchoalveolar lavage fluid (BALF) CD4/CD8 ratio for diagnosing sarcoidosis has been reported in many studies with variable results. Therefore, we performed a meta-analysis to estimate the overall diagnostic accuracy of BALF CD4/CD8 ratio based on the bulk of published evidence.
  
  
  METHODS
  Studies published prior to June 2015 and indexed in PubMed, OVID, Web of Science, Scopus and other databases were evaluated for inclusion. Data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled from included studies. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deeks's funnel plot was used to detect publication bias.
  
  
  RESULTS
  Sixteen publications with 1885 subjects met our inclusion criteria and were included in this meta-analysis. Summary estimates of the diagnostic performance of the BALF CD4/CD8 ratio were as follows: sensitivity, 0.70 (95%CI 0.64-0.75); specificity, 0.83 (95%CI 0.78-0.86); PLR, 4.04 (95%CI 3.13-5.20); NLR, 0.36 (95%CI 0.30-0.44); and DOR, 11.17 (95%CI 7.31-17.07). The area under the SROC curve was 0.84 (95%CI 0.81-0.87). There was no evidence of publication bias.
  
  
  CONCLUSIONS
  Measuring the BALF CD4/CD8 ratio may assist in the diagnosis of sarcoidosis when interpreted in parallel with other diagnostic factors.
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Yongchun
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Caishuang
authors.initials: C
authors.lastname: Pang
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Diandian
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Wan
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Zenglin
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China. Electronic address: lchens@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China. Electronic address: wenfuqiang.scu@gmail.com.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Wen
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology* / Q000276:immunology*; D016516:CD4-CD8 Ratio; D006801:Humans; D017594:Publication Bias; D012372:ROC Curve; D015203:Reproducibility of Results; D012507:Sarcoidosis / Q000175:diagnosis* / Q000276:immunology*; D012680:Sensitivity and Specificity
keywords: Bronchoalveolar lavage fluid; CD4/CD8 ratio; Meta-analysis; Sarcoidosis