Antibody-Based Detection Tests for the Diagnosis of Helicobacter pylori Infection in Children A Meta-Analysis 英文参考文献.docVIP
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Antibody-Based Detection Tests for the Diagnosis of Helicobacter pylori Infection in Children A Meta-Analysis 英文参考文献
Antibody-BasedDetectionTestsfortheDiagnosisof
HelicobacterpyloriInfectioninChildren:AMeta-Analysis
YeldaA.Leal1*,LauraL.Flores2,LauraB.Garc?′a-Corte′s1,RobertoCedillo-Rivera1,JavierTorres3
1Unidad de Investigacio′n Me′dica Yucata′n (UIMY), Unidad Me′dica de Alta Especialidad de Me′rida, Instituto Mexicano del Seguro Social, Me′rida, Yucata′n, Me′xico,
2DivisionofPulmonaryandCriticalCareMedicine,SanFranciscoGeneralHospitalandtheUniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesof
America, 3Unidad de Investigacio′n Me′dica en Enfermedades Infecciosas y Parasitarias (UIMEIP)–Hospital de Pediatr?′a Centro Me′dico Nacional Siglo XXI, Instituto
MexicanodelSeguroSocial,D.F.,Mexico
Abstract
Background:NumerousserologictestsareavailableforthediagnosisofH.pyloriinfectioninchildren.Commondesignsof
antibody-baseddetectiontestsareELISAandWesternBlot(WB).Fordevelopingcountrieswithlimitedlaboratoryresources
andaccess,ELISAwouldbethepreferredmethodbecauseofitssimplicity,lowercostandspeed.AlthoughinadultsELISA
hasproventobehighlyaccurateindiagnosingH.pyloriinfection;inchildren,ithasshownvariableaccuracy.
Methods/Findings: We conducted a systematic review and meta-analysis to assess the accuracy of antibody-based
detection tests for the diagnosis of H. pylori infection in children. Selection criteria included participation of at least 30
children and the use of a gold standard for H. pylori diagnosis. In a comprehensive search we identified 68 studies.
Subgroupanalyseswerecarriedoutbytechnique,immunoglobulinclass,andsourceoftest(commercialandin-house).The
resultsdemonstrated:1)WBtestsshowedhighoverallperformance,sensitivity91.3%(95%CI,88.9–93.3),specificity89%
(95%CI,85.7–91.9),LR+8.2(95%CI,5.1–13.3),LR20.06(95%CI,0.02–0.16),DOR158.8(95%CI,57.8–435.8);2)ELISA-IgG
assaysshowedlowsensitivity79.2%(95%CI,77.3–81.0)andhighspecificity(92.4%,95%CI,91.6–93.3);3)ELISAcommercial
testsvariedwidelyinperformance(testforheterogeneityp,0.0001);and4)In-houseELISAwithwhole-cell
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