H Xu1, Y Li, J M Qian. 1. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Abstract
OBJECTIVE: This meta-analysis assessed the value of interferon-γ release assays (IGRAs) in the differential diagnosis of intestinal tuberculosis (ITB) from Crohn's disease (CD). METHODS: Systematic search without language restriction was conducted in the main computerized databases until June 2015. Studies that have evaluated the performance of IGRAs (QuantiFERON-TB Gold or T-SPOT.TB) in distinguishing ITB from CD were eligible. Main outcome measures included sensitivity and specificity. Area under the curve (AUC) of the summary receiver operating characteristic (sROC) curve was used to evaluate the accuracy of IGRAs. RESULTS: Twelve studies (all from Asia) were finally included. The pooled sensitivity and specificity of IGRAs for the differential diagnosis of ITB from CD were 82.8% (95%CI 78.4%-86.6%) and 86.7% (95%CI 83.2%-89.6%) respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.870 (95%CI 5.345-8.830) and 0.171 (95%CI 0.105-0.279). The diagnostic odds ratio was 44.030 (95%CI 27.964-69.325). And the AUC of sROC was 0.939. CONCLUSIONS: IGRAs have a high sensitivity and specificity for the diagnosis of ITB, and specificity is consistent from study to study. IGRAs may be considered as a supplementary method in the differential diagnosis of ITB from CD.
OBJECTIVE: This meta-analysis assessed the value of interferon-γ release assays (IGRAs) in the differential diagnosis of intestinal tuberculosis (ITB) from Crohn's disease (CD). METHODS: Systematic search without language restriction was conducted in the main computerized databases until June 2015. Studies that have evaluated the performance of IGRAs (QuantiFERON-TB Gold or T-SPOT.TB) in distinguishing ITB from CD were eligible. Main outcome measures included sensitivity and specificity. Area under the curve (AUC) of the summary receiver operating characteristic (sROC) curve was used to evaluate the accuracy of IGRAs. RESULTS: Twelve studies (all from Asia) were finally included. The pooled sensitivity and specificity of IGRAs for the differential diagnosis of ITB from CD were 82.8% (95%CI 78.4%-86.6%) and 86.7% (95%CI 83.2%-89.6%) respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.870 (95%CI 5.345-8.830) and 0.171 (95%CI 0.105-0.279). The diagnostic odds ratio was 44.030 (95%CI 27.964-69.325). And the AUC of sROC was 0.939. CONCLUSIONS: IGRAs have a high sensitivity and specificity for the diagnosis of ITB, and specificity is consistent from study to study. IGRAs may be considered as a supplementary method in the differential diagnosis of ITB from CD.