IntroductionTuberculous peritonitis remains a diagnostic challenge for clinicians. Many studies have investigated the usefulness of adenosine deaminase (ADA) in ascites for the diagnosis of tuberculous peritonitis; however, the overall diagnostic accuracy of ADA for tuberculous peritonitis remains unclear. The aim of the present meta-analysis was to determine the overall accuracy of ADA measurements in the diagnosis of tuberculous peritonitis.Material and methodsWe performed a systematic search in PubMed and Embase to identify published studies that evaluated the diagnostic role of ADA for tuberculous peritonitis. Quality was assessed according to standardized Quality Assessment of Diagnostic Accuracy Studies criteria. Sensitivity, specificity and other measures of accuracy of ADA assay in order to diagnose tuberculous peritonitis were pooled using random effects models. Summary receiver operating characteristic curve (SROC) was used to summarize overall test performance.ResultsSixteen studies met inclusion criteria for the present meta-analysis. The pooled sensitivity and specificity for diagnosing tuberculous peritonitis were 0.93 (95% CI: 0.89–0.95) and 0.96 (95% CI: 0.94–0.97), respectively. The positive likelihood ratio was 15.80 (95% CI: 10.87–22.95), negative likelihood ratio was 0.09 (95% CI: 0.05–0.16) and diagnostic odds ratio was 249.28 (95% CI: 113.11–549.39). The area under the SROC was 0.98.ConclusionsAscitic ADA determination is a relatively sensitive and specific test for the diagnosis of tuberculous peritonitis. Measurement of ADA in ascites is thus likely to be a useful diagnostic method for tuberculous peritonitis.

Objective: The aim of the present study was to establish the predictive values of neutrophil CD64 expression in diagnosing neonatal infection. Methods: A comprehensive search of the PubMed and Embase Õ literature databases identified outcome data from published studies estimating the diagnostic accuracy of neutrophil CD64 expression for neonatal infection. Summary estimates for sensitivity, specificity, diagnostic odds ratios (DOR) and the area under the summary receiver operating characteristic curve (AUC) were calculated using a bivariate random-effects approach. Results: Twelve studies including 1915 neonates were analysed. Summary estimates (95% confidence intervals) for CD64 expression in the diagnosis of neonatal infection were: sensitivity, 0.78 (0.75, 0.81); specificity, 0.81 (0.78, 0.83); DOR, 21.27 (11.71, 38.65); positive-likelihood ratio, 4.53 (3.22, 6.36); negative-likelihood ratio, 0.23 (0.14, 0.37); AUC, 0.89. Conclusions: Neutrophil CD64 expression can be used as an additional test in the diagnosis of neonatal infection. Results of a CD64 assay should not be used alone to diagnose such infections, but should be interpreted in combination with other test results and clinical findings.

Background: Lung cancer is a leading cause of cancer mortality, and it shows a high incidence worldwide. Circulating microRNAs have been proposed as diagnostic indicators of lung cancer, but inconsistent results in the literature have prevented their widespread use in diagnosis. The present meta-analysis aimed to systematically evaluate the diagnostic accuracy of circulating microRNAs for lung cancer. Methods: Several research databases were searched systematically for studies of the accuracy of circulating microRNAs as diagnostic indicators of lung cancer. Results from different studies were pooled using random-effects models. Summary receiver operating characteristic (SROC) curves were used to assess the overall performance of microRNA-based assays. Results: Thirteen publications were included in the meta-analysis. The following summary estimates were obtained for the performance of circulating microRNAs in lung cancer diagnosis: sensitivity, 0.85 (95% confidence intervals [CI]: 0.83-0.87); specificity, 0.84 (95% CI: 0.81-0.86); positive likelihood ratio, 5.23 (95% CI: 3.75-7.29); negative likelihood ratio, 0.20 (95% CI: 0.14-0.27); and diagnostic odds ratio, 31.77 (95% CI: 16.98-59.42). The SROC curve indicated a maximum joint sensitivity and specificity of 0.85, with an area under the curve of 0.92. Conclusion: Circulating microRNAs show significant potential as diagnostic markers of lung cancer. The results of this meta-analysis justify larger, more rigorous studies to confirm such a diagnostic role.

Numerous studies have investigated the utility of MOC-31 in the diagnosis of malignant effusions. However, the results remain controversial. The aim of this study is to determine the overall accuracy of MOC-31 for malignant effusions through a meta-analysis of published studies. Publications addressing the accuracy of MOC-31 in the diagnosis of malignant effusions were selected from the PubMed, Embase, and Cochrane Library. Data from selected studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratios (LRs), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve. Statistical analysis was performed by Meta-Disc 1.4 and STATA 12.0 software. Eighteen studies, based on 1,748 patients, met the inclusion criteria for the meta-analysis, and the summary estimating for MOC-31 in the diagnosis of malignant effusions were sensitivity 0.85 (95%CI 0.83-0.87), specificity 0.97 (95%CI 0.96-0.99), positive likelihood ratio (PLR) 23.81 (95%CI 15.59-36.37), negative likelihood ratio (NLR) 0.12 (95%CI 0.07-0.20), and diagnostic odds ratio 214.18 (95%CI 99.96-458.93). The SROC curve indicated that the maximum joint sensitivity and specificity (Q value) was 0.95; the area under the curve was 0.98. Our findings suggest that MOC-31 may be a useful diagnostic tool with high sensitivity and specificity for differentiating malignant effusions and benign effusions.