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.	尉艳霞, 童朝晖, 龚娟妮, 等.腺苷脱氨酶诊断结核性胸膜炎价值的再评价.中华结核和呼吸杂志, 2010, 33(4):273-275.
2.	Porcel JM. Tuber culous pleural effusion. Lung, 2009, 187(2):263-270.
3.	Gaïni S, Koldkjær 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.	刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定:用于系统评价诊断性研究质量的工具.中国循证医学杂志, 2007, 7(4):296-306.
5.	李盈, 顾怀婷. 《中国循证医学杂志》发表系统评价/Meta分析的文献计量分析.中国循证医学杂志, 2012, 12(10):1279-1282.
6.	Penny F, Marie E, Weswood A, 等. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版).中国循证医学杂志, 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, 孙炳奇.胸水ADA、CRP、PCT联合检测在结核性胸膜炎中的诊断价值.医药前沿, 2013(12):165-166.
12.	牛瑞虹, 戎雪冰, 李丰, 等.降钙素原在鉴别结核性和恶性胸腔积液中的应用价值.临床肺科杂志, 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.	黄宇筠. HS-CRP联合PCT在鉴别类肺炎性、结核性和恶性胸腔积液的有效性研究.中山大学, 2010.
16.	韩锐, 孙耕耘.降钙素原和癌胚抗原联合检测在恶性胸腔积液中的诊断价值.安徽医科大学学报, 2009, 44(2):184-196.
17.	王信杰, 杜向阳.降钙素原与腺苷脱氨酶联合检测诊断结核性胸腔积液.山东大学学报, 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.	陈炜, 赵磊, 王锁柱, 等.炎性生物标记物在革兰氏阴性菌血流感染患者早期诊断的价值.中华急诊医学杂志, 2014, 23(3):303-307.
21.	宋秀琴, 时兢, 谢卫星, 等.降钙素原与全身性感染的相关性研究.中国急救医学, 2003, 23(10):676-677.

1. 尉艳霞, 童朝晖, 龚娟妮, 等.腺苷脱氨酶诊断结核性胸膜炎价值的再评价.中华结核和呼吸杂志, 2010, 33(4):273-275.
2. Porcel JM. Tuber culous pleural effusion. Lung, 2009, 187(2):263-270.
3. Gaïni S, Koldkjær 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. 刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定:用于系统评价诊断性研究质量的工具.中国循证医学杂志, 2007, 7(4):296-306.
5. 李盈, 顾怀婷. 《中国循证医学杂志》发表系统评价/Meta分析的文献计量分析.中国循证医学杂志, 2012, 12(10):1279-1282.
6. Penny F, Marie E, Weswood A, 等. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版).中国循证医学杂志, 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, 孙炳奇.胸水ADA、CRP、PCT联合检测在结核性胸膜炎中的诊断价值.医药前沿, 2013(12):165-166.
12. 牛瑞虹, 戎雪冰, 李丰, 等.降钙素原在鉴别结核性和恶性胸腔积液中的应用价值.临床肺科杂志, 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. 黄宇筠. HS-CRP联合PCT在鉴别类肺炎性、结核性和恶性胸腔积液的有效性研究.中山大学, 2010.
16. 韩锐, 孙耕耘.降钙素原和癌胚抗原联合检测在恶性胸腔积液中的诊断价值.安徽医科大学学报, 2009, 44(2):184-196.
17. 王信杰, 杜向阳.降钙素原与腺苷脱氨酶联合检测诊断结核性胸腔积液.山东大学学报, 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. 陈炜, 赵磊, 王锁柱, 等.炎性生物标记物在革兰氏阴性菌血流感染患者早期诊断的价值.中华急诊医学杂志, 2014, 23(3):303-307.
21. 宋秀琴, 时兢, 谢卫星, 等.降钙素原与全身性感染的相关性研究.中国急救医学, 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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