Potential Diagnostic Value of Serum p53 Antibody for Detecting Esophageal Cancer: A Meta-Analysis

Background

Mutant p53 protein overexpression has been reported to induce serum antibodies against p53. Various studies assessing the diagnostic value of serum p53 antibody in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of serum p53 antibody in esophageal cancer.

Methods

We systematically searched PubMed and Embase until 31st May 2012, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). Positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures diagnostic odds ratio (DOR) and symmetric summary receiver operating characteristic (sROC). The PLR and NLR and their 95% confidence interval (CI) were calculated using a fixed effects model according to the Mantel-Haensed method and random effects model based on the work of Der Simonian and laird, respectively.

Results

Fifteen studies (cases = 1079, controls = 2260) met the inclusion criteria for the meta-analysis. Approximately 53.33% (8/15) of the included studies were of high quality (QUADAS score≥8), which were retrospective case-control studies. The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of esophageal cancer were PLR 6.95 (95% CI: 4.77–9.51), NLR 0.75 (95%CI: 0.72–0.78) and DOR 9.65 (95%CI: 7.04–13.22). However, we found significant heterogeneity between NLRs.

Conclusions

The current evidence suggests serum p53 antibody has a potential diagnostic value for esophageal cancer. However, its discrimination power is not perfect because of low sensitivity.

Impact

These results suggest that s-p53-antibody may be useful for monitoring residual tumor cells and for aiding in the selection of candidates for less invasive treatment procedures because of the high specificity of s-p53-antibody. Further studies may need to identify patterns of multiple biomarkers to further increase the power of EC detection.     

Diagnostic Performance of Whole-Body PET/MRI for Detecting Malignancies in Cancer Patients: A Meta-Analysis

BackgroundAs an evolving imaging modality, PET/MRI is preliminarily applied in clinical practice. The aim of this study was to assess the diagnostic performance of PET/MRI for tumor staging in patients with various types of cancer.MethodsRelevant articles about PET/MRI for cancer staging were systematically searched in PubMed, EMBASE, EBSCO and the Cochrane Library. Two researchers independently selected studies, extracted data and assessed the methodological quality using the QUADAS tool. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated per patient and per lesion. The summary receiver-operating characteristic (SROC) curves were also constructed, and the area under the curve (AUC) and Q* estimates were obtained.ResultsA total of 38 studies that involved 753 patients and 4234 lesions met the inclusion criteria. On a per-patient level, the pooled sensitivity and specificity with 95% confidence intervals (CIs) were 0.93 (0.90–0.95) and 0.92 (0.89–0.95), respectively. On a per-lesion level, the corresponding estimates were 0.90 (0.88–0.92) and 0.95 (0.94–0.96), respectively. The pooled PLR, NLR and DOR estimates were 6.67 (4.83–9.19), 0.12 (0.07–0.21) and 75.08 (42.10–133.91) per patient and 10.91 (6.79–17.54), 0.13 (0.08–0.19) and 102.53 (59.74–175.97) per lesion, respectively.ConclusionAccording to our results, PET/MRI has excellent diagnostic potential for the overall detection of malignancies in cancer patients. Large, multicenter and prospective studies with standard scanning protocols are required to evaluate the diagnostic value of PET/MRI for individual cancer types.     

Assessment of the Potential Diagnostic Role of Anaplastic Lymphoma Kinase for Inflammatory Myofibroblastic Tumours: A Meta-Analysis

Objective

To assess the value of anaplastic lymphoma kinase for the diagnosis of inflammatory myofibroblastic tumours using a comprehensive meta-analysis.

Methods

We searched the related literature using electronic databases and manual searches. Approximately 454 cases from several countries were included in this analysis. The quality of studies included was assessed by QUADAS (quality assessment of studies of diagnostic accuracy). The diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), sensitivity and specificity were calculated to assess the role of anaplastic lymphoma kinase in the diagnosis of inflammatory myofibroblastic tumours. The overall test performance was summarised by an SROC (summary receiver operating characteristic curve). The heterogeneity and publication bias were analysed using Meta-regression and Deeks'' test. All data were analysed by Stata 12.0 software.

Results

Eight studies were included according to our inclusion criteria. The overall results for the specificity, sensitivity, PLR, NLR, DOR and area under the curve (AUC) were 0.99 (95% CI 0.82-1.00), 0.67 (95% CI 0.46-0.83), 0.67 (95% CI 0.46-0.83), 60.6 (95% CI 3.3-1112.4), 0.33 (95% CI 0.19-0.60), 181 (95% CI 9-3684) and 0.95 (95% CI 0.93-0.97), respectively, while the specificity, sensitivity, PLR, NLR, DOR and AUC for bladder IMTs were 0.99 (95% CI 0.67-1.00), 0.86 (95% CI 0.58-0.96), 95.6 (95% CI 2.0-4616.2), 0.14 (95% CI 0.04-0.50), 671 (95% CI 16-28913) and 0.99 (95% CI 0.97-0.99), respectively.

Conclusion

The present meta-analysis indicated that anaplastic lymphoma kinase plays a significant role in the differential diagnosis of inflammatory myofibroblastic tumours, particularly for inflammatory myofibroblastic tumours of the urinary bladder.     

Diagnostic value of nucleic acid amplification tests on bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis: a meta-analysis

The diagnosis of smear-negative pulmonary tuberculosis (SNPT) remains a clinical challenge. Many studies suggest that nucleic acid amplification tests (NAATs) on bronchoalveolar lavage fluid (BALF) plays a role in diagnosing SNPT, but with considerable varying results. The current study aimed to summarize the overall diagnostic accuracy of NAATs assay on BALF for SNPT. A systematic literature search was performed and data were retrieved. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) were calculated. A summary receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the overall diagnostic performance. All the statistical analysis was performed by using STATA 12.0 and Meta-DiSc 1.4 software. A total of nine studies with 1214 subjects were included this meta-analysis. The pooled sensitivity, specificity, PLR, NLR and DOR were 0.54 [95% CI (confidence interval): 0.48–0.59], 0.97 (95% CI: 0.95–0.98), 12.13 (95% CI: 8.23–17.88), 0.36 (95% CI: 0.23–0.56) and 44.71 (95% CI: 22.30–89.63) respectively. The AUC was 0.96. Estimated positive and negative post-probability values for a SNPT prevalence of 20% were 82% and 7% respectively. No publication bias was identified. Current available evidence indicated that NAATs on BALF may play a role in diagnosing SNPT, whereas the results should be interpreted in parallel with clinical information of patients and the results of traditional tests. Further studies should be performed to confirm our findings.     

Diagnostic Value of Mutation-Specific Antibodies for Immunohistochemical Detection of Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancer: A Meta-Analysis

Background

Various studies have assessed the diagnostic accuracy of EGFR mutation-specific antibodies in non-small cell lung cancer (NSCLC). We performed a meta-analysis of existing data to investigate the diagnostic value of mutation-specific antibodies for detection of EGFR mutations in NSCLC.

Methods

We systematically retrieved relevant studies from PubMed, Web of Knowledge, and Google Scholar. Data from studies that met the inclusion criteria were extracted for further exploration of heterogeneity, including calculation of the average sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and analysis of SROC(summary receiver operating characteristic) curves.

Results

Fifteen studies met our inclusion criteria. A summary of the meta-analysis of the efficacy of the anti-E746-A750 antibody was as follows: sensitivity, 0.60 (95% CI, 0.55–0.64); specificity, 0.98 (95% CI, 0.97–0.98); PLR, 33.50 (95% CI, 13.96–80.39); NLR, 0.39 (95% CI, 0.30–0.51) and DOR, 111.17 (95% CI, 62.22–198.63). A similar meta-analysis was performed for the anti-L858R antibody with results as follows: sensitivity, 0.76 (95% CI, 0.71–0.79); specificity, 0.96 (95% CI, 0.95–0.97); PLR, 24.42 (95% CI, 11.66–51.17); NLR, 0.22 (95% CI, 0.12–0.39) and DOR, 126.66 (95% CI, 54.60–293.82).

Conclusion

Immunohistochemistry alone is sufficient for the detection of EGFR mutations if the result is positive. Molecular-based analyses are necessary only if the anti-E746-A750 antibody results are negative. Immunohistochemistry seems more suitable for clinical screening for EGFR mutations prior to molecular-based analysis.     

16S Ribosomal Ribonucleic Acid Gene Polymerase Chain Reaction in the Diagnosis of Bloodstream Infections: A Systematic Review and Meta-Analysis

ObjectiveWe aim to evaluate the accuracy of the 16S ribosomal ribonucleic acid (rRNA) gene polymerase chain reaction (PCR) test in the diagnosis of bloodstream infections through a systematic review and meta-analysis.MethodsA computerized literature search was conducted to identify studies that assessed the diagnostic value of 16S rRNA gene PCR test for bloodstream infections. Study quality was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence intervals (95% CI) for each study. Summary receiver operating characteristic (SROC) curve was used to summarize overall test performance. Statistical analysis was performed in Meta-DiSc 1.4 and Stata/SE 12.0 software.ResultsTwenty-eight studies were included in our meta-analysis. Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85–0.89), 0.94 (95% CI, 0.93–0.95), 12.65 (95% CI, 8.04–19.90), 0.14 (95% CI, 0.08–0.24), and 116.76 (95% CI, 52.02–262.05), respectively. The SROC curve indicated that the area under the curve (AUC) was 0.9690 and the maximum joint sensitivity and specificity (Q*) was 0.9183. In addition, heterogeneity was statistically significant but was not caused by the threshold effect.ConclusionExisting data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis. Further prospective studies are needed to assess the diagnostic value of PCR amplification and DNA microarray hybridization of 16S rRNA gene in the future.     

Role of Transthoracic Lung Ultrasonography in the Diagnosis of Pulmonary Embolism: A Systematic Review and Meta-Analysis

Background

Pulmonary embolism (PE) is a potentially life-threatening condition. Although computed tomography pulmonary angiography (CTPA) is the reference standard for diagnosis, its early diagnosis remains a challenge, and the concerns about the radiation exposures further limit the general use of CTPA. The primary aim of this meta-analysis was to evaluate the overall diagnostic accuracy of transthoracic lung ultrasound (TLS) in the diagnosis of PE.

Methods

PubMed, Web of science, OvidSP, ProQuest, EBSCO, Cochrane Library and Clinicaltrial.gov were searched systematically. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and hierarchical summary receiver operating characteristic (HSROC) curves were used to examine the TS performance. The Bayes analysis was used to calculate the post-test probability of PE. Publication bias was assessed with Deeks funnel plot.

Results

The results indicated that the sensitivity, specificity, PLR and NLR were 0.85 (95% confidence interval (CI), 0.78 to 0.90), and 0.83 (95% CI, 0.73 to 0.90). And the DOR and HSROC were 28.82 (95% CI, 17.60 to 47.21), 0.91(95% CI, 0.88, 0.93).

Conclusions

The present meta-analysis suggested that transthoracic lung ultrasonography is helpful in diagnosing pulmonary embolism. Although the application of transthoracic lung ultrasound may change some patients’ diagnostic processes, it is inappropriate to generally use transthoracic ultrasonography in diagnosing pulmonary embolism currently.     

Diagnostic Value of Circulating Chromogranin A for Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Background

In previous decades, chromogranin A (CgA) has been demonstrated to be the most promising biomarker for the diagnosis of neuroendocrine tumors (NETs), but its diagnostic value is still controversial. This meta-analysis aimed to estimate the potential diagnostic value of circulating CgA for NETs.

Methods

We collected relevant studies from several electronic databases as well as from reference lists. Diagnostic indices of CgA were pooled with random effects models. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) curves for the diagnosis of NETs were used to estimate the overall diagnostic efficiency.

Results

Through a search strategy, 13 studies met the inclusion criteria and were included. These studies contained 1260 patients with NETs and 967 healthy controls in the total sample. As a result, the overall sensitivity, specificity and diagnostic odds ratio (DOR) were 0.73 (95% CI: 0.71 to 0.76), 0.95 (95% CI: 0.93 to 0.96) and 56.29 (95% CI: 25.27 to 125.38), respectively, while the summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 14.56 (95% CI: 6.62 to 32.02) and 0.26 (95% CI: 0.18 to 0.38), respectively. In addition, the area under the curve (AUC) of the circulating CgA in the diagnosis of NETs was 0.8962.

Conclusions

These data demonstrate that circulating CgA is an efficient biomarker for the diagnosis of NETs with high sensitivity and specificity, which indicates that it may be helpful for the clinical management of NETs. However, further studies are needed to clarify this issue.     

Hemoglobin A1c for Diagnosis of Postpartum Abnormal Glucose Tolerance among Women with Gestational Diabetes Mellitus: Diagnostic Meta-Analysis

Objective

To evaluate the accuracy of glycosylated hemoglobin A1c (HbA1c) for the diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus (GDM).

Methods

After a systematic review of related studies, the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and other measures about the accuracy of HbA1c in the diagnosis of postpartum abnormal glucose tolerance were pooled using random-effects models. The summary receiver operating characteristic (SROC) curve was used to summarize the overall test performance.

Results

Six studies met our inclusion criteria. The pooled results on SEN, SPE, PLR, NLR, and DOR were 0.36 (95% CI 0.23–0.52), 0.85 (95% CI 0.73–0.92), 2.4 (95% CI 1.6–3.6), 0.75 (95% CI 0.63–0.88) and 3 (95% CI 2–5). The area under the summary receiver operating characteristic (SROC) curve was 0.67 with a Q value of 0.63.

Conclusions

Measurement of HbA1c alone is not a sensitive test to detect abnormal glucose tolerance in women with prior GDM.     

血常规在头颈部鳞状细胞癌早期诊断中的作用

目的:探究血常规指标在头颈部鳞状细胞癌早期诊断中的作用,从血液学的角度为头颈部鳞状细胞癌的早期诊断提供参考依据。方法:对181例头颈部良恶性肿瘤患者的血常规结果进行回顾性分析,比较头颈部鳞状细胞癌患者组(实验组)和头颈部良性肿瘤组(对照组)患者的血小板计数(PLT)、血小板比积(PCT)、血小板平均容积(MPV)、血小板分布宽度(PDW)、大血小板比率(P-LCR)、中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、单核细胞计数(MONO)、嗜酸性粒细胞计数(EOS)、嗜碱性粒细胞计数(BASO)、血小板计数/淋巴细胞计数比值(PLR)以及中性粒细胞计数/淋巴细胞计数比值(NLR)共12个指标。结果:实验组和对照组的PLT、PCT、MPV、PDW、P-LCR以及BASO计数值比较均没有统计学差异(p0.05)。对照组NEU、MONO、EOS、PLR和NLR均低于实验组,而LYM计数值高于实验组,其差异均具有统计学意义(p0.05),ROC曲线显示NLR对于早期诊断的意义要优于PLR。结论:血小板相关指标在头颈部鳞状细胞癌早期诊断中无明显意义,白细胞亚型计数具有重要的提示作用,而NLR的诊断意义要高于PLR,或许可以联合其他鳞癌标志物进行早期诊断。     

Use of Anti-Granulocyte Scintigraphy with 99mTc-Labeled Monoclonal Antibodies for the Diagnosis of Periprosthetic Infection in Patients after Total Joint Arthroplasty: A Diagnostic Meta-Analysis

The accurate diagnosis of periprosthetic joint infections (PJI) is crucial for therapy and the prevention of complications. No diagnostic test of PJI is 100% accurate. The aim of this study was to assess the use of anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies to diagnose PJI after total joint arthroplasty. A systematic search of all relevant studies published through January 2013 was conducted using the MEDLINE, EMBASE, OVID, and ScienceDirect databases. Observational studies that assessed the accuracy of the anti-granulocyte scintigraphy with monoclonal antibodies or antibody fragments labeled with technetium 99 m in diagnosis for PJI and provided data on specificity and sensitivity were identified. Standard methods recommended for meta-analysis of diagnostic accuracy were used. Nineteen studies were eligible for inclusion. The results demonstrated that the area under the summary receiver operator curve was 0.88, and the diagnostic accuracy (Q*) was 0.81. Additionally, the diagnostic odds ratio (DOR) was 18.76 with a corresponding 95% confidence interval of 10.45–33.68. The pooled sensitivity and specificity of the diagnostic method for the diagnosis of PJI were 83% and 79%, respectively, while the pooled positive likelihood ratio (PLR) was 3.56, and the negative likelihood ratio (NLR) was 0.26. Anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies has a reasonable role in the diagnosis of PJI after total joint arthroplasty. Due to the limitations of the present meta-analysis, additional high-quality original studies are required to confirm the predictive value.     

Diagnostic Accuracy of Ber-EP4 for Metastatic Adenocarcinoma in Serous Effusions: A Meta-Analysis

Numerous studies have investigated the utility of Ber-EP4 in differentiating metastatic adenocarcinoma (MAC) from malignant epithelial mesothelioma (MM) and/or reactive mesothelial cells (RM) in serous effusions. However, the results remain controversial. The aim of this study is to determine the overall accuracy of Ber-EP4 in serous effusions for MAC through a meta-analysis of published studies. Publications addressing the accuracy of Ber-EP4 in the diagnosis of MAC were selected from the Pubmed, Embase and Cochrane Library. Data from selected studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratio (LR), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve. Statistical analysis was performed by Meta-Disc 1.4 and STATA 12.0 softwares. 29 studies, based on 2646 patients, met the inclusion criteria and the summary estimating for Ber-EP4 in the diagnosis of MAC were: sensitivity 0.8 (95% CI: 0.78–0.82), specificity 0.94 (95% CI: 0.93–0.96), positive likelihood ratio (PLR) 12.72 (95% CI: 8.66–18.7), negative likelihood ratio (NLR) 0.18 (95% CI: 0.12–0.26) and diagnostic odds ratio 95.05 (95% CI: 57.26–157.77). The SROC curve indicated that the maximum joint sensitivity and specificity (Q-value) was 0.91; the area under the curve was 0.96. Our findings suggest that BER-EP4 may be a useful diagnostic adjunctive tool for confirming MAC in serous effusions.     

血清淀粉样蛋白A、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值与急性化脓性阑尾炎患儿术后切口感染的关系

摘要 目的：探讨血清淀粉样蛋白A（SAA）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）与急性化脓性阑尾炎患儿术后切口感染的关系。方法：选择418例急性化脓性阑尾炎患儿,观察术后7 d内切口感染情况,根据术后感染情况分为感染组和未感染组。对比感染组和未感染组术前血清SAA、NLR、PLR。采用单因素和多因素Logistic回归模型分析术后切口感染的影响因素。绘制受试者工作特征（ROC）曲线评估术前血清SAA、NLR、PLR对急性化脓性阑尾炎患儿术后切口感染的预测价值。结果：418例急性化脓性阑尾炎患儿中,有54例出现术后切口感染,感染率为12.92%。感染组术前血清SAA、NLR、PLR高于未感染组（P<0.05）。术后切口感染与手术时间、手术方式有关（P<0.05）;而与性别、年龄、切口长度、发病至手术的平均时间无关（P>0.05）。术前手术时间偏长、血清SAA升高、NLR升高、PLR升高、手术方式为开腹是术后切口感染的危险因素（P<0.05）。术前血清SAA、NLR、PLR联合检测预测术后切口感染的效能大于各指标单独预测。结论：术前血清SAA水平及NLR、PLR在急性化脓性阑尾炎术后切口感染患儿中升高,三指标联合检测对术后切口感染发生具有较高的预测效能,血清SAA、NLR、PLR、手术时间、手术方式是术后切口感染的影响因素。     

Systematic review and meta-analysis of detecting galactomannan in bronchoalveolar lavage fluid for diagnosing invasive aspergillosis

Background

Bronchoalveolar lavage (BAL) galactomannan (GM) assay has been used for diagnosing invasive aspergillosis (IA). We aimed to derive a definitive estimate of the overall accuracy of BAL-GM for diagnosing IA.

Methods and Results

We undertook a systematic review of thirty diagnostic studies that evaluated the BAL-GM assay for diagnosing IA. PubMed and CBM (China Biological Medicine Database) databasees were searched for relevant studies published in all languages up until Feb 2012. The pooled diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) were constructed for each cutoff value. Additionally, pooled sensitivity (SEN), specificity (SPE), and positive and negative likelihood ratios (PLR and NLR, respectively) were calculated for summarizing overall test performance. Thirty studies were included in this meta-analysis. The summary estimates of pooled DOR, SEN, SPE, PLR, and NLR of the BAL-GM assay (cutoff value 0.5) for proven or probable IA were 52.7 (95% confidence interval (CI) 31.8–87.3), 0.87 (95% CI 0.79–0.92), 0.89 (95% CI 0.85–0.92), 8.0 (95% CI 5.7–11.1) and 0.15 (95% CI 0.10–0.23) respectively. The SROC was 0.94 (95% CI 0.92–0.96). Compared with cutoff value of 0.5, it has higher DOR, SPE and PLR, and similar SEN and NLR with cutoff value of 1.0, which indicated the optimal cutoff value might be 1.0. Compared with BAL-GM, serum GM has a lower SEN and higher SPE, while PCR displays a lower SEN and a similar SPE.

Conclusion

With the optimal cutoff value of 1.0, the BAL-GM assay has higher SEN compared to PCR and serum GM test. It is a useful adjunct in the diagnosis of proven and probable IA.     

The diagnostic value of miRNA-141 in prostate cancer: a systematic review and meta-analysis

MiR-141 has gradually demonstrated its value in the diagnosis of prostate cancer. However, the diagnostic parameters applied in previous studies were different. This systematic review was conducted to explore the diagnostic value of miR-141 in prostate cancer. A comprehensive search of related literature in PubMed, Medline, the Cochrane Library and Embase databases was performed. Seven studies were included which assessed the diagnostic value of miR-141 in patients with prostate cancer up to October 31, 2019. Meta-disc version 1.4 and STATA software version 12.0 were used to analyze the data. The pooled sensitivity and specificity were 0.70 (95% CI 0.64~0.75) and 0.73 (95% CI 0.64~0.80), respectively. The positive likelihood ratio (PLR) was 2.88 (95% CI 1.40~5.93), and negative likelihood ratio (NLR) was 0.38 (95% CI 0.20~0.71). The pooled diagnostic odds ratio (DOR) of miR-141 for prostate cancer was observed to be 9.94 (95% CI: 2.55~38.80). The summary area under the receiver operating characteristic (ROC) curve was 0.83 (95% CI: 0.79~0.86). The results of meta-regression suggested that heterogeneity was mainly derived from patient age. The Fagan nomogram results showed a significant increase when correlating miR-141 with the diagnosis of prostate cancer. This meta-analysis suggests that miR-141 has a high diagnostic value for prostate cancer. In future, large-scale prospective studies will be done to verify and evaluate this result.     

PLR、NLR、CRP与老年AECOPD患者病情严重程度、近期预后的关系

摘要 目的：探讨血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）、C反应蛋白（CRP）与老年慢性阻塞性肺疾病急性加重期（AECOPD）患者病情严重程度、近期预后的关系。方法：选取97例老年AECOPD患者为疾病组,另取同期31例体检健康者为对照组。测定两组受试者PLR、NLR、CRP水平,比较不同病情严重程度患者PLR、NLR、CRP水平,并分析PLR、NLR、CRP与患者近期预后的关系以及三者联合评估患者预后的价值。结果：疾病组PLR、NLR、CRP水平高于对照组（P<0.05）;随着病情严重程度加重,PLR、NLR、CRP水平依次升高（P<0.05）;预后不良组PLR、NLR、CRP水平高于预后良好组（P<0.05）;ROC曲线结果显示,PLR、NLR、CRP联合评估患者预后的AUC为0.943,高于单项评估（P<0.05）。结论：PLR、NLR、CRP水平变化均可以反映老年AECOPD患者病情严重程度,且可以用来评估预后,联合评估其价值更高。     

Evaluation of a New Cryptococcal Antigen Lateral Flow Immunoassay in Serum,Cerebrospinal Fluid and Urine for the Diagnosis of Cryptococcosis: A Meta-Analysis and Systematic Review

BackgroundA new lateral flow immunoassay (LFA) for the detection of cryptococcal antigen was developed.ObjectiveWe aimed to systematically review all relevant studies to evaluate the diagnostic accuracy of the cryptococcal antigen LFA on serum, CSF and urine specimens.MethodsWe searched public databases including PubMed, Web of Science, Elsevier Science Direct and Cochrane Library for the English-language literature published up to September 2014. We conducted meta-analyses of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratios (DOR) and SROC of LFA in serum and CSF, respectively. The sensitivity of LFA in urine was also analyzed. Subgroup analyses were carried out to analyze the potential heterogeneity.Results12 studies were included in this study. The pooled sensitivity and specificity values of LFA in serum were 97.6% (95% CI, 95.6% to 98.9%) and 98.1% (95% CI, 97.4% to 98.6%), respectively. The average PLR of LFA in serum was 43.787 (95% CI, 22.60–84.81) and the NLR was 0.03 (95% CI, 0.01–0.09). The pooled DOR was 2180.30 (95% CI, 868.92–5471.00) and the AUC was 0.9968. The pooled sensitivity and specificity values of LFA in CSF were 98.9% (95% CI, 97.9% to 99.5%) and 98.9% (95% CI, 98.0% to 99.5%), respectively. The average PLR of LFA in serum was 48.83 (95% CI, 21.59–110.40) and the NLR was 0.02 (95% CI, 0.01–0.04). The pooled DOR was 2931.10 (95% CI, 1149.20–7475.90) and the AUC was 0.9974. The pooled sensitivity value of LFA in urine was 85.0% (95% CI, 78.7% to 90.1%)ConclusionsThe study demonstrates a very high accuracy of LFA in serum and CSF for the diagnosis of cryptococcosis in patients at risk. LFA in urine can be a promising sample screening tool for early diagnosis of cryptococcosis.     

NLR、PLR、LMR与乳腺癌新辅助化疗疗效及预后的关系研究

摘要 目的：探讨化疗前外周血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）与乳腺癌患者新辅助化疗疗效及预后的关系。方法：选择2016年10月至2018年1月在安徽医科大学附属安庆第一人民医院进行新辅助化疗的乳腺癌患者105例为研究对象,根据新辅助化疗疗效分为病理完全缓解（pCR）组（26例）和非pCR组（79例）。比较pCR组和非pCR组化疗前外周血NLR、PLR、LMR;采用受试者工作特征（ROC）曲线分析化疗前外周血NLR、PLR、LMR对乳腺癌患者新辅助化疗病理疗效预测价值。所有患者术后随访5年,根据ROC曲线确定的NLR、PLR、LMR最佳截断值分为高NLR、PLR、LMR组和低NLR、PLR、LMR组,采用K-M生存曲线分析不同NLR、PLR、LMR组5年无病生存期（DFS）;单因素和多因素COX回归分析预后不良的影响因素。结果：pCR组化疗前NLR、PLR均低于非pCR组（P＜0.05）,LMR高于非pCR组（P＜0.05）。化疗前NLR、PLR、LMR三项联合预测新辅助化疗病理疗效的曲线下面积（AUC）均大于各指标单独预测。K-M生存曲线分析显示,化疗前高NLR、PLR组5年DFS分别低于低NLR、PLR组（P＜0.05）,高LMR组5年DFS高于低LMR组（P＜0.05）;多因素COX回归分析显示,NLR、PLR升高是乳腺癌预后的危险因素,LMR升高是保护因素（P<0.05）。结论：pCR组化疗前NLR、PLR更低,LMR更高,高NLR、PLR和低LMR患者5年DFS更低。NLR、PLR、LMR对新辅助化疗病理疗效具有一定的预测价值,三项联合能为乳腺癌的新辅助化疗评估提供重要参考依据。     

Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis

Introduction: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) which are used for assessment of axial spondyloarthritis (AxSpA) related disease activity have poor specificity and sensitivity. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) have not been investigated as disease activity markers among Asian AxSpA patients.

Methodology: A retrospective, cross-sectional study was conducted in Singapore General Hospital from January 2013 to December 2015 to investigate the role of NLR, PLR and MPV as disease activity markers in AxSpA patients.

Results: The mean age of patients (n?=?122) was 37.0?±?12.5 years old and majority of them were male (n?=?93, 76.2%). No significant differences were found between patients with disease with regards to age, gender, ethnicity, HLAB-27 status, age at onset of diagnosis of AxSpA, duration of disease and comorbidities such as cardiac disease (p?>?0.05).

There were no significant differences in the ESR, NLR, PLR and MPV between the four disease activity groups (p?>?0.05). However, patients with very high disease activity had higher ESR and CRP compared to patients with inactive disease and moderate disease activity (p?Conclusion: NLR, PLR and MPV were not associated with disease activity in Asian AxSpA patients.     

NLR、PLR与分化型甲状腺癌术后131I清甲效果的关系及其预测价值分析

摘要 目的：探讨中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）与分化型甲状腺癌（DTC）术后碘131（¹³¹I）清甲治疗效果的关系及对DTC术后¹³¹I清甲效果的预测价值。方法：选择2019年3月至2021年12月在江苏大学附属徐州医院行甲状腺切除术且术后进行¹³¹I清甲治疗的DTC患者150例为研究对象,根据¹³¹I清甲治疗效果分为清甲成功组（107例）和清甲未成功组（43例）,通过检查血常规获得中性粒细胞计数、血小板计数、淋巴细胞计数并计算NLR、PLR,比较两组NLR、PLR;采用单因素及多因素logistics回归模型分析¹³¹I清甲疗效的影响因素,采用受试者工作特征曲线（ROC）分析NLR、PLR对¹³¹I清甲治疗效果的预测价值。结果：清甲成功组NLR、PLR低于清甲未成功组（P＜0.05）,单因素分析显示清甲成功组促甲状腺激素（TSH）高于清甲未成功组,甲状腺球蛋白（Tg）水平低于清甲未成功组,清甲成功组病灶最大径小于清甲未成功组（P＜0.05）;多因素logistics回归分析显示,高NLR、PLR、Tg是¹³¹I清甲治疗失败的独立危险因素（P＜0.05）;NLR、PLR及联合检测预测¹³¹I清甲治疗效果的ROC曲线下面积（AUC）分别为0.760、0.732、0.829,NLR与PLR联合检测的AUC高于二者单独检测。结论：高NLR、PLR是DTC术后¹³¹I清甲未成功的独立危险因素,早期检测NLR、PLR对DTC术后¹³¹I清甲治疗效果具有较好的预测价值。