摘要
目的评价宏基因组二代测序技术检测脑脊液在结核性脑膜炎诊断中的应用价值。方法通过计算机检索PubMed、Embase、Cochrane Library、中国知网、万方、维普等数据库。中文检索词:宏基因组二代测序、二代测序、结核、结核性脑膜炎;英文检索词:metagenomic next-generation sequencing、mNGS、next-generation sequencing、tuberculosis、tuberculous meningitis、tuberculosis meningitis。收集从建库至2021年4月30日发表的宏基因组二代测序技术应用于脑脊液检测诊断结核性脑膜炎的相关文献,由2名研究者独立进行文献检索、筛选、数据提取,质量评价。以MetaDisc 1.4软件进行Meta分析。结果检索出628篇文献,依据纳入和排除标准最终纳入7篇文献,包含477例患者,其中结核性脑膜炎患者231例。Meta分析结果显示,宏基因组二代测序技术检测脑脊液诊断结核性脑膜炎的汇总敏感度为62.0%(95%CI:55.0%~68.0%)、汇总特异度为97.0%(95%CI:94.0%~99.0%)、汇总阳性似然比为10.57(95%CI:4.84~23.11)、汇总阴性似然比为0.41(95%CI:0.27~0.60)、汇总诊断OR值为21.39(95%CI:10.18~44.95)、汇总受试者工作特征曲线下面积为0.956。结论宏基因组应用于脑脊液检测对结核性脑膜炎具有较高的诊断价值,可作为快速诊断结核性脑膜炎的有效方法。
Objective To evaluate the diagnostic value of metagenomic next-generation sequencing(mNGS on cerebrospinal fluid for detecting tuberculous meningitis(TBM). Methods Literature on diagnosing TBM by mNGS assay on cerebrospinal fluid were collected by searching PubMed,Embase,Cochrane Library,CNKI,WanFang and VIP databases,enrolling literature recorded from database establishment to April 30,2021.Both Chinese and English key words were “metagenomic next-generation sequencing”“mNGS”“next-generation sequencing”“tuberculosis”“tuberculosis meningitis”and “tuberculous meningitis”. Then two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed the quality of included studies.MetaDisc 1.4 were used to conduct meta-analysis. Results Six hundred and twenty-eight articles were retrieved,and 7 articles were finally included according to the inclusion and exclusion criteria,involving 477 cases among whom 231 cases were diagnosed as TBM patients.Meta analysis showed that the pooled sensitivity and specificity of mNGS on cerebrospinal fluid in the diagnosis of TBM were 62.0%(95.0%CI:55.0%-68.0%)and 97.0%(95.0%CI:94.0%-99.0%),while the pooled positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio were 10.57(95%CI:4.84-23.11),0.41(95%CI:0.27-0.60),21.39(95%CI:10.18-44.95)respectively.The pooled area under the curve of receiver operating characteristic was0.956. Conclusion mNGS on cerebrospinal fluid plays a valuable role in the diagnosis of TBM and can be used as an effective method for rapid diagnosis.
作者
陈文
姚利
陈康
戴希勇
CHEN Wen;YAO Li;CHEN Kang;DAI Xi-yong(Depxrtment of Infectious Disease,Daye City People's Hospital,Huangshi,Hubei,Daye 435100,China)
出处
《中国防痨杂志》
CAS
CSCD
2021年第10期1066-1072,共7页
Chinese Journal of Antituberculosis
关键词
宏基因组二代测序
结核
脑膜
诊断
META分析
Metagenomic next-generation sequencing
Tuberculosis
meningeal
Diagnosis
Meta-analysis
