An Updated Systematic Review and Meta-Analysis for the Diagnostic Test Accuracy of Ascitic Fluid Adenosine Deaminase in Tuberculous Peritonitis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Tuberculous peritonitis is difficult to diagnose due to its non-specific clinical manifestations and lack of proper diagnostic modalities. Current meta-analysis was performed to find the overall diagnostic accuracy of adenosine deaminase (ADA) in diagnosing tuberculous peritonitis. Materials and Methods: PubMed, Google Scholar, and Cochrane library were searched to retrieve the published studies which assessed the role of ascitic fluid ADA in diagnosing tuberculous peritonitis from Jan 1980 to June 2022. This meta-analysis included 20 studies and 2,291 participants after fulfilling the inclusion criteria. Results: The pooled sensitivity was 0.90 (95% confidence interval [CI]: 0.85 - 0.94) and pooled specificity was 0.94 (95% CI: 0.92 - 0.95). The positive likelihood ratio was 15.20 (95% CI: 11.70 - 19.80), negative likelihood ratio was 0.10 (95% CI: 0.07 - 0.16) and diagnostic odds ratio was 149 (95% CI: 86 - 255). The area under the summary receiver operating characteristic curve was 0.97. Cut- off value and sample size were found to be the sources of heterogeneity in the mete-regression analysis. Conclusion: Ascitic fluid ADA is a useful test for the diagnosis of tuberculous peritonitis with good sensitivity and specificity however, with very low certainty of evidence evaluated by Grading of Recommendations, Assessment, Development and Evaluation approach. Further well- designed studies are needed to validate the diagnostic accuracy of ascitic fluid ADA for tuberculous peritonitis.
Abstract
Background: Tuberculous peritonitis is difficult to diagnose due to its non-specific clinical manifestations and lack of proper diagnostic modalities. Current meta-analysis was performed to find the overall diagnostic accuracy of adenosine deaminase (ADA) in diagnosing tuberculous peritonitis. Materials and Methods: PubMed, Google Scholar, and Cochrane library were searched to retrieve the published studies which assessed the role of ascitic fluid ADA in diagnosing tuberculous peritonitis from Jan 1980 to June 2022. This meta-analysis included 20 studies and 2,291 participants after fulfilling the inclusion criteria. Results: The pooled sensitivity was 0.90 (95% confidence interval [CI]: 0.85 - 0.94) and pooled specificity was 0.94 (95% CI: 0.92 - 0.95). The positive likelihood ratio was 15.20 (95% CI: 11.70 - 19.80), negative likelihood ratio was 0.10 (95% CI: 0.07 - 0.16) and diagnostic odds ratio was 149 (95% CI: 86 - 255). The area under the summary receiver operating characteristic curve was 0.97. Cut- off value and sample size were found to be the sources of heterogeneity in the mete-regression analysis. Conclusion: Ascitic fluid ADA is a useful test for the diagnosis of tuberculous peritonitis with good sensitivity and specificity however, with very low certainty of evidence evaluated by Grading of Recommendations, Assessment, Development and Evaluation approach. Further well- designed studies are needed to validate the diagnostic accuracy of ascitic fluid ADA for tuberculous peritonitis.
참고문헌 (40)
- Chakaya J, "The WHO Global Tuberculosis 2021 Report-not so good news and turning the tide back to End TB", Int J Infect Dis, 124(Suppl 1), pp.S26~9 (2022)
- Debi U, "Abdominal tuberculosis of the gastrointestinal tract : revisited", World J Gastroenterol, 20, pp.14831~14840 (2014)
- Ben Ayed H, "Extrapulmonary tuberculosis : Update on the Epidemiology, Risk Factors and Prevention Strategies", Int J Trop Dis, 1, pp.006~ (2018)
- Rathi P, "Abdominal Tuberculosis", J Assoc Physicians India, 64, pp.38~47 (2016)
- Cho JK, "Clinical features and outcomes of abdominal tuberculosis in southeastern Korea : 12 years of experience", BMC Infect Dis, 18, pp.699~ (2018)
- Srivastava U, "Tuberculous peritonitis", Radiol Case Rep, 9, pp.971~ (2015)
- Sharma MP, "Abdominal tuberculosis", Indian J Med Res, 120, pp.305~315 (2004)
- Maulahela H, "Recent advances in the diagnosis of intestinal tuberculosis", BMC Gastroenterol, 22, pp.89~ (2022)
- Abu-Zidan FM, "Diagnosis of abdominal tuberculosis : lessons learned over 30 years : pectoral assay", World J Emerg Surg, 14, pp.33~ (2019)
- Bhargava DK, "Adenosine deaminase(ADA)in peritoneal tuberculosis : diagnostic value in ascitic fluid and serum", Tubercle, 71, pp.121~126 (1990)
- Light RW, "Update on tuberculous pleural effusion", Respirology, 15, pp.451~458 (2010)
- Riquelme A, "Value of adenosine deaminase(ADA)in ascitic fluid for the diagnosis of tuberculous peritonitis : a meta-analysis", J Clin Gastroenterol, 40, pp.705~710 (2006)
- Shen YC, "Diagnostic accuracy of adenosine deaminase for tuberculous peritonitis : a meta-analysis", Arch Med Sci, 9, pp.601~607 (2013)
- Tao L, "Diagnostic value of adenosine deaminase in ascites for tuberculosis ascites : a meta-analysis", Diagn Microbiol Infect Dis, 79, pp.102~107 (2014)
- McInnes MDF, "Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies : the PRISMA-DTA statement", JAMA, 319, pp.388~396 (2018)
- Whiting PF, "QUADAS-2 : a revised tool for the quality assessment of diagnostic accuracy studies", Ann Intern Med, 155, pp.529~536 (2011)
- Walter SD, "Properties of the summary receiver operating characteristic(SROC)curve for diagnostic test data", Stat Med, 21, pp.1237~1256 (2002)
- Deeks JJ, "The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed", J Clin Epidemiol, 58, pp.882~893 (2005)
- Blake J, "The use of adenosine deaminase assays in the diagnosis of tuberculosis", S Afr Med J, 62, pp.19~21 (1982)
- Bhargava DK, "Adenosine deaminase(ADA)in peritoneal tuberculosis : diagnostic value in ascitic fluid and serum", Tubercle, 71, pp.121~126 (1990)
- Brant CQ, "The value of adenosine deaminase(ADA)determination in the diagnosis of tuberculous ascites", Rev Inst Med Trop São Paulo, 37, pp.449~453 (1995)
- Hillebrand DJ, "Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States", Hepatology, 24, pp.1408~1412 (1996)
- Sathar MA, "Ascitic fluid gamma interferon concentrations and adenosine deaminase activity in tuberculous peritonitis", Gut, 36, pp.419~421 (1995)
- Burgess LJ, "The use of adenosine deaminase as a diagnostic tool for peritoneal tuberculosis", Tuberculosis(Edinb), 81, pp.243~248 (2001)
- Sharma SK, "Diagnostic accuracy of ascitic fluid IFN-gamma and adenosine deaminase assays in the diagnosis of tuberculous ascites", J Interferon Cytokine Res, 26, pp.484~488 (2006)
- Hong KD, "Comparison between laparoscopy and noninvasive tests for the diagnosis of tuberculous peritonitis", World J Surg, 35, pp.2369~2375 (2011)
- Kang SJ, "Role of ascites adenosine deaminase in differentiating between tuberculous peritonitis and peritoneal carcinomatosis", World J Gastroenterol, 18, pp.2837~2843 (2012)
- Saleh MA, "Use of adenosine deaminase measurements and QuantiFERON in the rapid diagnosis of tuberculous peritonitis", J Med Microbiol, 61, pp.514~519 (2012)
- Huang HJ, "Diagnostic feature of tuberculous peritonitis in patients with cirrhosis : a matched case-control study", Exp Ther Med, 7, pp.1028~1032 (2014)
- Ali N, "Role of ascitic fluid adenosine deaminase(ADA)and serum CA-125 in the diagnosis of tuberculous peritonitis", Bangladesh Med Res Counc Bull, 40, pp.89~91 (2014)
- Shadia K, "Adenosine deaminase assay in different body fluids for the diagnosis of tubercular infection", Am J Biomed Life Sci, 3, pp.49~54 (2015)
- Lee JY, "A rapid and non-invasive 2-step algorithm for diagnosing tuberculous peritonitis using a T cell-based assay on peripheral blood and peritoneal fluid mononuclear cells together with peritoneal fluid adenosine deaminase", J Infect, 70, pp.356~366 (2015)
- Liu R, "Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB", RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China, 2020, pp.90, 119~124
- Kumabe A, "Utility of ascitic fluid adenosine deaminase levels in the diagnosis of tuberculous peritonitis in general medical practice", Can J Infect Dis Med Microbiol, 2020, pp.5792937~ (2020)
- Nguyen HM, "Using ascitic fluid adenosine deaminase assay in the diagnosis of tuberculous ascites", J Gastroenterol Hepatol Res, 9, pp.3124~3127 (2020)
- Sun J, "The negative impact of increasing age and underlying cirrhosis on the sensitivity of adenosine deaminase in the diagnosis of tuberculous peritonitis : a cross-sectional study in eastern China", Int J Infect Dis, 110, pp.204~212 (2021)
- Amol Sonyabapu Dahale, "Reappraisal of the Role of Ascitic Fluid Adenosine Deaminase for the Diagnosis of Peritoneal Tuberculosis in Cirrhosis", 대한소화기학회지, 78(3), pp.168~176 (2021), 대한소화기학회[DOI]
- Thiruveedhula CS, "Assessment of adenosine deaminase levels and lypmhocyte counts in tubercular ascitis", Int J Health Sci, 6(Suppl 3), pp.6707~6713 (2022)
- Liao YJ, "Adenosine deaminase activity in tuberculous peritonitis among patients with underlying liver cirrhosis", World J Gastroenterol, 18, pp.5260~5265 (2012)
- Yin X, "Diagnostic value of Lipoarabinomannan antigen for detecting Mycobacterium tuberculosis in adults and children with or without HIV infection", J Clin Lab Anal, 36, pp.e24238~ (2022)