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Diagnostic and clinical significance of antigen-specific pancreatic antibodies in inflammatory bowel diseases: A meta-analysis

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World Journal of Gastroenterology 2020年第2期26卷 246-265页

作者： konstantinos gkiouras Maria G Grammatikopoulou Xenophon Theodoridis Eirini Pagkalidou Evangelia Chatzikyriakou Anna G Apostolidou Eirini I Rigopoulou Lazaros I Sakkas Dimitrios Petrou Bogdanos Department of Rheumatology and Clinical Immunology Faculty of MedicineSchool of Health SciencesUniversity of ThessalyBiopolisLarissa GR41110Greece Faculty of Medicine School of Health SciencesAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Department of Nutritional Sciences and Dietetics School of Health SciencesInternational Hellenic UniversitySindos CampusThessaloniki GR57400Greece Laboratory of Hygiene Social and Preventive Medicine and Medical StatisticsFaculty of MedicineSchool of Health SciencesAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Laboratory of Clinical Neurophysiology AHEPA University HospitalFaculty of MedicineAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Department of Medicine and Research Laboratory of Internal Medicine University Hospital of LarissaBiopolisLarissa GR41110Greece Division of Transplantation Immunology and Mucosal BiologyMRC Centre for TransplantationKing's College London Medical SchoolLondon GR41110United Kingdom

BACKGROUND Non-invasive criteria are needed for Crohn’s disease(CD)diagnosis,with several biomarkers being *** of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic autoantibodies-to-glycoprotein-2(anti-GP2)tests for the diagnosis of CD appear *** To systematically review and meta-analyze evidence on the diagnostic accuracy of anti-GP2 tests in patients with suspected/confirmed *** An electronic search was conducted on PubMed,Cochrane-CENTRAL and grey literature(CRD42019125947).The structured research question in PICPTR format was“Population”including patients with symptoms akin to CD,the“Index test”being anti-GP2 testing,the“Comparator”involved standard CD diagnosis,the“Purpose of test”being diagnostic,“Target disorder”was CD,and the“Reference standard”included standard clinical,radiological,endoscopical,and histological CD diagnostic *** was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and hierarchical models were employed to synthesize the *** Out of 722 studies retrieved,15 were *** studies had industry-related conflicts-of-interest,and most included healthy donors as controls(spectrum bias).For the combination of IgA and/or IgG anti-GP2 test,the summary sensitivity was 20%(95%confidence interval:10%-29%)at a median specificity of 97%.If the test was applied in 10000 suspected patients,9669 would be true negatives and in 26,the diagnosis would be *** this hypothetical cohort,the anti-GP2 would fail to produce a diagnosis for 81.3%of the positive *** summary points of sensitivity and high specificity were estimated for the IgG or IgA anti-GP2 *** results were observed when the analyses were restricted using specific cut-offs,or when ulcerative colitis patients were used as *** Anti-GP2 tests demonstrate low sensitivity and high *** results indicate that caution is required

关键词： Inflammatory bowel disease Gastrointestinal disease Evidence-based diagnosis Sensitivity Specificity Ulcerative colitis Conflicts of interest Metaregression Industry bias

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