Diagnostic Value of Procalcitoninfor Tuberculous Pleural Effusion: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 JIANGYao-wen , LIUPeng , TANGShi-yuan ,  HUHai

Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

HUHai, Email: hhtg2014@126.com

Keywords：

Procalcitonin(PCT); Pleural effusion; Tuberculous; Diagnosis; Meta-analysis

DOI：

10.7507/1672-2531.20140121

Video：

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Objective To systematically review the diagnostic value of procalcitonin (PCT) for tuberculous pleural effusion. Methods We electronically searched CNKI, WanFang Data, VIP, CBM, PubMed, The Cochrane Library and EMbase from inception to April, 2013, to collect the literature about the diagnostic value of PCT for tuberculous pleural effusion compared with gold standard (positive outcomes of mycobacterium tuberculosis culture). Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. MetaDiSc 1.4 were used to conduct the meta-analysis. Results Eight studies were finally included. The results of meta-analysis showed the pooled sensitivity and specificity were 0.63 (95%CI 0.58 to 0.68) and 0.76 (95%CI 0.70 to 0.81), respectively. The positive likelihood ratio and negative likelihood ratio were 2.72 (95%CI 1.48 to 5.02) and 0.49 (95%CI 0.29 to 0.82), respectively. The diagnostic odds ratio (DOR) was 5.77 (95%CI 1.89 to 17.58). And the SROC AUC was 0.79. Heterogeneity was mainly derived from the QUADAS score and Begg's test showed there was no presence of publication bias. Conclusion PCT is a potential marker in the diagnosis of benign and tuberculous pleural effusion, which can be used to determine diagnosis identification of tuberculous pleural effusion.

Citation： JIANGYao-wen, LIUPeng, TANGShi-yuan, HUHai. Diagnostic Value of Procalcitoninfor Tuberculous Pleural Effusion: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(6): 716-720. doi: 10.7507/1672-2531.20140121 Copy

1.	?尉艷霞, 童朝暉, 龔娟妮, 等.腺苷脫氨酶診斷結核性胸膜炎價值的再評價.中華結核和呼吸雜志, 2010, 33(4):273-275.
2.	Porcel JM. Tuber culous pleural effusion. Lung, 2009, 187(2):263-270.
3.	Ga?ni S, Koldkj?r OG, Pedersen SS. Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis:a prospective study. Critical Care, 2006, 10(2):R53.
4.	刁驤, 艾昌林, 秦莉, 等譯. QUADAS的制定:用于系統評價診斷性研究質量的工具.中國循證醫學雜志, 2007, 7(4):296-306.
5.	李盈, 顧懷婷. 《中國循證醫學雜志》發表系統評價/Meta分析的文獻計量分析.中國循證醫學雜志, 2012, 12(10):1279-1282.
6.	Penny F, Marie E, Weswood A, 等. QUADAS評價:一種用于診斷性研究的質量評價工具(修訂版).中國循證醫學雜志, 2007, 7(7): 531-536.
7.	Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet, 1993, 341(844): 515-518.
8.	Ugarte H, Silva E, Mercan D, et al. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med, 1999, 27(3):498-504.
9.	Meisner M, Tschaikowsky K, Palmaers T, et al. Comparison of procalcitonin(PCT) and C-reactive protein(CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care, 1999, 3(1):45-55.
10.	Luyt CE, Guerin V, CombesA, et al. Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(1):48-53.
11.	敖旭照, 孫炳奇.胸水ADA、CRP、PCT聯合檢測在結核性胸膜炎中的診斷價值.醫藥前沿, 2013(12):165-166.
12.	牛瑞虹, 戎雪冰, 李豐, 等.降鈣素原在鑒別結核性和惡性胸腔積液中的應用價值.臨床肺科雜志, 2008, 18(8):1529-1530.
13.	Porcel JM, Vives M, Cao G, et al. Biomarkers of infection for the differential diagnosis of pleural effusions. Eur Respir, 2009, 34(6):1383-1389.
14.	Cakir E, Deniz O, Ozcan O, et al. Pleural fluid and serum procalcitonin as diagnostic tools in tuberculous pleurisy. Clinical biochemistry, 2005, 38(3):234-238.
15.	黃宇筠. HS-CRP聯合PCT在鑒別類肺炎性、結核性和惡性胸腔積液的有效性研究.中山大學, 2010.
16.	韓銳, 孫耕耘.降鈣素原和癌胚抗原聯合檢測在惡性胸腔積液中的診斷價值.安徽醫科大學學報, 2009, 44(2):184-196.
17.	王信杰, 杜向陽.降鈣素原與腺苷脫氨酶聯合檢測診斷結核性胸腔積液.山東大學學報, 2009, 50(9):79-82.
18.	Wang CY, Hsiao YC. Diagnostic value of procalcitonin in pleural effusions. Eur J Clin Microbiol Infect Dis, 2011, 30(3):313-318.
19.	Assicot M, Bohuon C, Gendrel D, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet, 1993, 341(8844):515-518.
20.	陳煒, 趙磊, 王鎖柱, 等.炎性生物標記物在革蘭氏陰性菌血流感染患者早期診斷的價值.中華急診醫學雜志, 2014, 23(3):303-307.
21.	宋秀琴, 時兢, 謝衛星, 等.降鈣素原與全身性感染的相關性研究.中國急救醫學, 2003, 23(10):676-677.

1. ?尉艷霞, 童朝暉, 龔娟妮, 等.腺苷脫氨酶診斷結核性胸膜炎價值的再評價.中華結核和呼吸雜志, 2010, 33(4):273-275.
2. Porcel JM. Tuber culous pleural effusion. Lung, 2009, 187(2):263-270.
3. Ga?ni S, Koldkj?r OG, Pedersen SS. Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis:a prospective study. Critical Care, 2006, 10(2):R53.
4. 刁驤, 艾昌林, 秦莉, 等譯. QUADAS的制定:用于系統評價診斷性研究質量的工具.中國循證醫學雜志, 2007, 7(4):296-306.
5. 李盈, 顧懷婷. 《中國循證醫學雜志》發表系統評價/Meta分析的文獻計量分析.中國循證醫學雜志, 2012, 12(10):1279-1282.
6. Penny F, Marie E, Weswood A, 等. QUADAS評價:一種用于診斷性研究的質量評價工具(修訂版).中國循證醫學雜志, 2007, 7(7): 531-536.
7. Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet, 1993, 341(844): 515-518.
8. Ugarte H, Silva E, Mercan D, et al. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med, 1999, 27(3):498-504.
9. Meisner M, Tschaikowsky K, Palmaers T, et al. Comparison of procalcitonin(PCT) and C-reactive protein(CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care, 1999, 3(1):45-55.
10. Luyt CE, Guerin V, CombesA, et al. Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(1):48-53.
11. 敖旭照, 孫炳奇.胸水ADA、CRP、PCT聯合檢測在結核性胸膜炎中的診斷價值.醫藥前沿, 2013(12):165-166.
12. 牛瑞虹, 戎雪冰, 李豐, 等.降鈣素原在鑒別結核性和惡性胸腔積液中的應用價值.臨床肺科雜志, 2008, 18(8):1529-1530.
13. Porcel JM, Vives M, Cao G, et al. Biomarkers of infection for the differential diagnosis of pleural effusions. Eur Respir, 2009, 34(6):1383-1389.
14. Cakir E, Deniz O, Ozcan O, et al. Pleural fluid and serum procalcitonin as diagnostic tools in tuberculous pleurisy. Clinical biochemistry, 2005, 38(3):234-238.
15. 黃宇筠. HS-CRP聯合PCT在鑒別類肺炎性、結核性和惡性胸腔積液的有效性研究.中山大學, 2010.
16. 韓銳, 孫耕耘.降鈣素原和癌胚抗原聯合檢測在惡性胸腔積液中的診斷價值.安徽醫科大學學報, 2009, 44(2):184-196.
17. 王信杰, 杜向陽.降鈣素原與腺苷脫氨酶聯合檢測診斷結核性胸腔積液.山東大學學報, 2009, 50(9):79-82.
18. Wang CY, Hsiao YC. Diagnostic value of procalcitonin in pleural effusions. Eur J Clin Microbiol Infect Dis, 2011, 30(3):313-318.
19. Assicot M, Bohuon C, Gendrel D, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet, 1993, 341(8844):515-518.
20. 陳煒, 趙磊, 王鎖柱, 等.炎性生物標記物在革蘭氏陰性菌血流感染患者早期診斷的價值.中華急診醫學雜志, 2014, 23(3):303-307.
21. 宋秀琴, 時兢, 謝衛星, 等.降鈣素原與全身性感染的相關性研究.中國急救醫學, 2003, 23(10):676-677.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Procalcitoninfor Tuberculous Pleural Effusion: A Meta-Analysis

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