Systematic review with meta-analysis: Accuracy of interferon-gamma releasing assay and anti-Saccharomyces cerevisiae antibody in differentiating intestinal tuberculosis from Crohn's disease in Asians
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摘要Background and Aims: Distinguishing Crohn's disease (CD) from intestinal tuberculosis (ITB) is a clinical challenge. This meta-analysis assessed the clinical usefulness of Interferon-gamma releasing assay (IGRA) and anti-Saccharomyces cerevisiae antibody (ASCA) in the diagnosis of ITB and CD, respectively. Methods: Systematic search without language restriction was conducted in AMED, EBM, MEDLINE, EMBASE, and Google Scholar until September 2013. Studies that have evaluated performance of IGRA (QuantiFERON-TB Gold or T-SPOT.TB) or ASCA in distinguishing ITB from CD were eligible. Main outcome measures included sensitivity and specificity. Random-effects models were used to combine estimates from studies with significant heterogeneity. Area under the curve (AUC) was used to measure accuracy of the tests. Results: Eleven studies (five IGRA, three ASCA, three IGRA and ASCA) involving 1081 subjects were included. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of IGRA for the diagnosis of ITB was 81% (95% CI, 75-86%), 85% (95% CI, 81-89%), 6.02 (95% CI: 4.62-7.83), and 0.19 (95% CI: 0.10-0.36), respectively. The AUC was 0.92. The pooled sensitivity and specificity of ASCA for the diagnosis of CD was 33% (95% confidence interval [CI], 27%-38%) and 83% (95% CI, 77-88%), respectively with an AUC of 0.58. T-SPOT.TB showed a higher sensitivity than QuantiFERON-TB Gold for the diagnosis of ITB. Conclusions: IGRA and ASCA have a high specificity for the diagnosis of ITB. Both IGRA and ASCA may have a supplementary role in the differential diagnosis between ITB and CD when conventional workup is not diagnostic. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
著者Ng S.C., Hirai H.W., Tsoi K.K.F., Wong S.H., Chan F.K.L., Sung J.J.Y., Wu J.C.Y.
期刊名稱Journal of Gastroenterology and Hepatology
出版年份2014
月份1
日期1
卷號29
期次9
出版社Blackwell Publishing Inc.
出版地United Kingdom
頁次1664 - 1670
國際標準期刊號0815-9319
電子國際標準期刊號1440-1746
語言英式英語
關鍵詞ASCA, Crohn's disease, IGRA, Tuberculosis

上次更新時間 2020-17-09 於 03:28