ABSTRACT
Objective To analyze the consistency of two rapid antigen assays for the diagnosis of influenza A and B. We evaluated the clinical usefulness of silver amplification immunochromatography influenza virus detection kit.Methods Nasopharyngeal swab samples were collected from patients who were suspected of influenza at Huashan Hospital between January and February 2015. Two samples were collected from the same one patient. The samples were tested simultaneously by using IMMUNO AG Cartridge Flu AB kit (AG1) and commercial immunochromatographic assay kit, Clearview exact influenza A&B (CV). PCR method was used as reference.Results A total of 91 samples were tested, of which 7 were positive for influenza A and 53 positive for influenza B by AG1 system; 7 positive for influenza A and 50 positive for influenza B by CV system; and 8 positive for influenza A and 60 positive for influenza B by PCR. The sensitivity and specificity of the AG1 system were 87.5 % and 100 % for influenza A, and 88.3 % and 100 % for influenza B; while the CV system showed sensitivity and specficity of 87.5 % and 100 % for influenza A, 83.3 % and 100 % for influenza B. The AG1 system was 100 % consistent with the CV system in the positive rate of influenza A, and 94.3 % consistent with the CV system in the positive rate of influenza B.Conclusions The AG1 system is well consistent with the conventional immunochromatography-based diagnostic tests in diagnosis of influenza. The AG1 system is useful in earlier diagnosis of influenza due to fewer human error in result interpretation.
ABSTRACT
Objective To assess the diagnostic value of transient elastography (TE) for the staging of liver fibrosis and cirrhosis in patients with chronic hepatitis C.Methods Systematic and comprehensive literatures related to diagnosis value of TE for chronic hepatitis C were searched in FMJS biomedical database (from Jan.1st,2003 to Aug.31st,2013).Full texts were obtained from PubMed,EBSCO,Elsevier Science,Ovid,Wiley database.The quality of the studies was rated with quality assessment of diagnostic accuracy studies (QUADAS).The accuracy of TE in diagnosing liver fibrosis and cirrhosis were assessed by Stata software bivariate mixed effects model.Results Twenty seven eligible studies which included 5 937 subjects were enrolled.The meta-analysis of fitting the bivariate mixed effects model showed that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and the area under curve (AUC) of summary receiver operating characteristic (SROC) for liver fibrosis were 0.75(95％CI:0.70-0.80),0.84(95％CI:0.78-0.88),4.70(95％CI:3.60-6.20),0.29(95％CI:0.24-0.36),16.00(95％CI:12.00-22.00) and 0.86(95％CI:0.83-0.89),respectively.And those for cirrhosis were 0.86(95％CI:0.82-0.89),0.89(95％CI:0.86-0.92),8.10(95％CI:6.30-10.40),0.16(95％CI:0.12-0.20),51.00(95％CI:35.00-76.00) and 0.94(95％CI:0.91-0.96),respectively.Conclusions TE shows better diagnostic accuracy for cirrhosis than for significant fibrosis in patients with chronic hepatitis C.More high quality trials are required to further confirm this finding.
ABSTRACT
Objective To assess the value of S index and FIB-4 for diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB) by comparing with traditional indexes APRI and Forns.Methods A total of 361 patients with confirmed CHB from the First Hospital of Nanjing Medical University and Huashan Hospital Affiliated to Fudan University during January 2006 and December 2011 were enrolled in the study.The clinical,laboratory and pathological data of patients were collected.Four noninvasive score systems APRI,Forns,S index and FIB-4 were computed.With liver biopsy as the gold standard,the area under the ROC curve (AUROC) was used to assess the value of above 4 score systems in diagnosis of liver fibrosis,and Z test was performed to evaluate the effectiveness of above systems.Results The areas under ROC curve (AUCs) of APRI,Forns,S index and FIB-4 for significant fibrosis (≥S2) were (0.737 ±0.027),(0.716 ± 0.028),(0.745 ± 0.026) and (0.781 ± 0.025),respectively.When the cut off value of FIB-4 was set at 1.62,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) for diagnosis of significant fibrosis were 59.3％,85.8％,89.4％ and 51.2％,respectively,which were better than Forn index (Z =3.28,P =0.001).While for S4 (cirrhosis) the AUCs of APRI,Foms,S index and FIB-4 were (0.687 ± 0.035),(0.792 ± 0.028),(0.863 ± 0.024) and (0.832 ± 0.025),respectively.When the cut off value of S index was set at 1.06,the sensitivity,specificity,PPV and NPV for diagnosis of cirrhosis were 77.9％,85.5％,59.4％ and 93.5％,respectively,which were better than APRI and Forns (Z =6.74 and 3.21,P ＜ 0.01).Conclusions APRI,Forns,S index and FIB-4 are simple and accurate methods for assessing liver fibrosis.FIB-4 and S index are better than APRI and Forns in diagnosis of significant fibrosis and cirrhosis,which may replace liver biopsy in certain extend.