title: The diagnostic value of polymerase chain reaction forMycobacterium tuberculosisto distinguish intestinal tuberculosis from crohn's disease: A meta-analysis.
abstract: OBJECTIVE
  Intestinal tuberculosis (ITB) and Crohn's disease (CD) are important differential diagnoses that can be difficult to distinguish. Polymerase chain reaction (PCR) for Mycobacterium tuberculosis (MTB) is an efficient and promising tool. This meta-analysis was performed to systematically and objectively assess the potential diagnostic accuracy and clinical value of PCR for MTB in distinguishing ITB from CD.
  
  
  METHODS
  We searched PubMed, Embase, Web of Science, Science Direct, and the Cochrane Library for eligible studies, and nine articles with 12 groups of data were identified. The included studies were subjected to quality assessment using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
  
  
  RESULTS
  The summary estimates were as follows: sensitivity 0.47 (95% CI: 0.42-0.51); specificity 0.95 (95% CI: 0.93-0.97); the positive likelihood ratio (PLR) 10.68 (95% CI: 6.98-16.35); the negative likelihood ratio (NLR) 0.49 (95% CI: 0.33-0.71); and diagnostic odds ratio (DOR) 21.92 (95% CI: 13.17-36.48). The area under the curve (AUC) was 0.9311, with a Q* value of 0.8664. Heterogeneity was found in the NLR. The heterogeneity of the studies was evaluated by meta-regression analysis and subgroup analysis.
  
  
  CONCLUSIONS
  The current evidence suggests that PCR for MTB is a promising and highly specific diagnostic method to distinguish ITB from CD. However, physicians should also keep in mind that negative results cannot exclude ITB for its low sensitivity. Additional prospective studies are needed to further evaluate the diagnostic accuracy of PCR.
authors.affiliation: The First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Jin
authors.affiliation: Department of Gastroenterology, Tongde, Hospital of Zhejiang Province, Zhejiang, China.
authors.forename: Baoying
authors.initials: B
authors.lastname: Fei
authors.affiliation: First School of Clinical Medicine Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterological Laboratory, Zhejiang Province People's Hospital, Zhejiang, China.
authors.forename: Xujun
authors.initials: X
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult