The Value Of PCR In Distinguishing Intestinal Tuberculosis From Crohn’s Disease:a Meta Analysis

Objective: 1.To explore the diagnostic value of PCR for ITB and CD.2.To investigate the effects of different samples and PCR methods on the diagnostic value of TB-PCR.3.To explore whether PCR can be used as an exclusion diagnostic tool for ITB.Methods: PubMed,EMBASE,CNKI and CBM were used to retrieve the study on the identification of ITB and CD by PCR from Jan.2000 to Jan.2018.QUADAS-2 was used for literature quality evaluation,and Meta analysis was performed using Revman5.3,MetaDisc1.4 and STATA12.0 software.The pooled diagnostic indicators were obtained.At the same time the summary receiver operating characteristic(SROC)curve was drawed and the area under the curve was calculated.At last,subgroup analysis,meta regression analysis,sensitivity analysis and publication bias were performed.Results: A total of 15 literatures were included,including 18 studies,involving 587 cases of ITB and 525 cases of CD.1.There is no heterogeneity caused by the threshold effect in all studies.After meta-regression analysis,no clear heterogeneity source was found.Then we drawed the ROC curve and calculated that SROC-AUC was 0.8957.2.Other pooled diagnostic indicators were as follow: pooled sensitivity and specificity were 0.45(95%CI:0.42-0.49)and 0.95(95%CI:0.92-0.96).Pooled positive likelihood ratio and negative likelihood ratio 6.51(95%CI:4.39-9.66)and 0.54(95%CI:0.42-0.70).The DOR was 15.36(95%CI:8.87-26.58).It can be speculated that sample sources and PCR methods may have a greater impact on heterogeneity,by reading literature and professional knowledge.The subgroup analysis also showed that the heterogeneity of the regional subgroup and sample capacity subgroup changed greatly,which may be the sources of the heterogeneity of this study.Conclusion: 1.TB-PCR has a high diagnostic efficiency,which can be used as an important reference for the clinical identification of ITB and CD.2.The positive results suggest that the possibility of ITB is large,but TB-PCR is not a confirmatory tool to diagnose ITB or to exclude CD.3.The results of each subgroup analysis showed that FQ-PCR was more effective than C-PCR,but the difference was not significant,and further study was needed.