ObjectiveTo systematically review the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in China. MethodsWe searched PubMed, The Cochrane Library (Issue 4, 2015), EMbase, CNKI, CBM, VIP and WanFang data from inception to April 2015, to collect diagnostic studies about HLA-B27 for AS in China. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. Pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Subgroup analysis was stratified by detection methods of HLA-B27. ResultsA total of 18 studies involving 22 comparisons, with 3 670 AS patients and 28 389 health controls were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.92 (95%CI 0.90 to 0.93), 0.94 (95%CI 0.94 to 0.95), 16.22 (95%CI 13.63 to 19.29), 0.08 (95%CI 0.06 to 0.10), and 256.49 (95%CI 168.25 to 391.00), respectively. The AUC of SROC was 0.98. The result of subgroup analysis showed that there was no significant difference for flow cytometry (FCM) and Polymerase Chain Reaction with Sequence-Specific Primer (PCR-SSP) in HLA-B27 detection for AS (Z=7.915, P=0.960). ConclusionCurrent evidence indicates that HLA-B27 detection is of great diagnostic value for AS. At present, FCM and PCR-SSP shows no significant difference in HLA-B27 detection for AS. Due to the limitation of the quality of included studies, and the exclusion of the suspected patients, higher quality studies are needed to verify the above conclusion.
ObjectiveTo explore the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in Chinese population. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 8, 2015), CNKI, and WanFang data from inception to August 2015, to collect diagnostic studies about HLA-B27 for AS in Chinese population. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed by using Stata12.0 software. ResultsA total of 16 studies involving 3137 AS and 5617 suspect patients were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, -LR and DOR were 0.91(95%CI 0.89 to 0.93), 0.94(95%CI 0.91 to 0.96), 14.90(95%CI 9.60 to 23.10), 0.09(95%CI 0.08 to 0.12) and 157.00(95%CI 90.00 to 275.00), respectively. The AUC of SROC was 0.98(95%CI 0.93 to 0.97). ConclusionsHLA-B27 detection is of great diagnostic value for AS in Chinese population. However, due to the limited quality and quantity of the included studies, more long-term follow-up prospective studies are needed to verify the above conclusion.