摘要
目的采用Meta分析方法综合定量评价国内外焦磷酸测序技术快速诊断异烟肼耐药的诊断价值。方法检索PubMed、Web of Science、Elsevier、中国知识资源总库（CNKI）、万方和维普，制定文献纳入排除标准，对纳入文献进行质量评分，提取纳入研究的特征信息。检验异质性并根据其结果选择相应的效应模型；采用Meta—Discl．4和Statal0．0软件进行综合定量分析；最后进行敏感性分析。结果检索相关文献114篇，最后纳入9篇。将焦磷酸测序与常规测序相比，其结果一致率100％。以细菌学药敏为金标准．焦磷酸测序检测katG基因时标本总数945份，加权敏感度、特异度及95％可信区间分别是0．77（0．73，0．80），1．00（O．99，1．00）。SROC曲线下面积为98．82％，纳入文献稳定性好。只检测inhA基因时的加权敏感度为0．19（0．15，0．24）、特异度为1．00（0．98，1．00）。结论焦磷酸测序技术检测结核分枝杆菌异烟肼耐药性有很高的特异度，在异烟肼耐药初筛时具有很高的临床价值，是药敏检测的有效辅助手段。（中华检验医学杂志，2013，36：329-332）
Objective To evaluate the accuracy of pyrosequencing for the mutation detection of katG gene in isoniazid resistance in Mycobacterium tuberculosis using Meta-analysis. Methods Searching PnbMed, Web of Science, Elsevier, and China National Knowledge Infrastructure （CNKI）, Weipu and WANFANG DATA to obtain the relevant English and Chinese-language articles, respectively. A written protocol and explicit study selection criteria was followed. Quality of included trials was assessed by QUADAS （ quality assessment of diagnostic accuracy studies）. Subsequently, the characteristics of the included articles were appraised and extracted. Heterogeneity of the included articles was tested by using STATA 10. 0, which was used to select proper effect model. The fixed effects model was adopted using Meta-Disc software. Finally, sensitivity analysis was performed. Results Totally 114 research papers were collected and 9 articles were selected. The accordance between pyrosequencing and conventional sequencing result was 100%. Eight studies were involved including 945 specimens when katG gene was detected. The overall sensitivity and specificity were 0. 77 （0. 73, 0. 80） and 1.00 （0. 99, 1.00） , respectively. The area under the SROC was 0. 9882. As inhA gene was detected, the overall sensitivity and specificity were 0. 19 （0. 15, 0. 24） and 1.00 （0. 98, 1.00 ）. The test was stable. Conclusions Our meta-analysis reveals that pyrosequencing is a highly specific tool for detection mutation of katG gene of isoniazid resistance. This result suggests that it is useful for screening of isoniazid resistance in diagnostic test. （ Chin J Lab Med,2013,36： 329-332 ）
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2013年第4期329-332,共4页
Chinese Journal of Laboratory Medicine
基金
基金项目：国家十二五重大专项资助项目（2012zxl0003002JD08）
上海市科委项目资助项目（10411955100、11ZRl430200）
关键词
序列分析
DNA
分枝杆菌
结核
异烟肼
抗药性
细菌
META分析
Sequence analysis, DNA
Mycobacterium tuberculosis
Isoniazid
Drugresistance, bacterial
Meta-analysis
