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Saudi J Gastroenterol. 2017 Jan-Feb;23(1):3-10. doi: 10.4103/1319-3767.199135.

The diagnostic value of polymerase chain reaction for Mycobacterium tuberculosis to distinguish intestinal tuberculosis from crohn's disease: A meta-analysis.

Author information

  • 1The First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China.
  • 2Department of Gastroenterology, Tongde, Hospital of Zhejiang Province, Zhejiang, China.
  • 3First School of Clinical Medicine Wenzhou Medical University, Wenzhou, Zhejiang, China.
  • 4Department of Gastroenterological Laboratory, Zhejiang Province People's Hospital, Zhejiang, China.

Abstract

BACKGROUND/AIM:

Intestinal tuberculosis (ITB) and Crohn's disease (CD) are important differential diagnoses that can be difficult to distinguish. Polymerase chain reaction (PCR) for Mycobacterium tuberculosis (MTB) is an efficient and promising tool. This meta-analysis was performed to systematically and objectively assess the potential diagnostic accuracy and clinical value of PCR for MTB in distinguishing ITB from CD.

MATERIALS AND METHODS:

We searched PubMed, Embase, Web of Science, Science Direct, and the Cochrane Library for eligible studies, and nine articles with 12 groups of data were identified. The included studies were subjected to quality assessment using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

RESULTS:

The summary estimates were as follows: sensitivity 0.47 (95% CI: 0.42-0.51); specificity 0.95 (95% CI: 0.93-0.97); the positive likelihood ratio (PLR) 10.68 (95% CI: 6.98-16.35); the negative likelihood ratio (NLR) 0.49 (95% CI: 0.33-0.71); and diagnostic odds ratio (DOR) 21.92 (95% CI: 13.17-36.48). The area under the curve (AUC) was 0.9311, with a Q* value of 0.8664. Heterogeneity was found in the NLR. The heterogeneity of the studies was evaluated by meta-regression analysis and subgroup analysis.

CONCLUSIONS:

The current evidence suggests that PCR for MTB is a promising and highly specific diagnostic method to distinguish ITB from CD. However, physicians should also keep in mind that negative results cannot exclude ITB for its low sensitivity. Additional prospective studies are needed to further evaluate the diagnostic accuracy of PCR.

PMID:
28139494
DOI:
10.4103/1319-3767.199135
[PubMed - in process]
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