A Systematic Review of Procalcitonin for Early Detection of Septicemia of Newborn

56 [ ] 167-3619(009)03-056-05 Journal of Tropical Medicine Vol.9 No.3 Mar.009 * ( 510515) (PCT) CNKI VIP PCT QUADAS Metadisc1.4 DOR (SROC) SROC (AUC) Review Manager5 Meta 8 ; 7 8 (χ =3.8P=0.858I =0.0%) 8 0.914 0.935AUC 0.9783;7 (χ =3.4P=0.779I =0.0%) 0.876 0.943AUC 0.9578 PCT ; ; ; :R7.131 :A A Systematic Review of Procalcitonin for Early Detection of Septicemia of Newborn WANG Feng-ping LIU Fei WANG Qian QIU Yu-rong RUI Yong-yu * (Department of Clinical Laboratory Nanfang Hospital Southern Medical University Guangzhou 510515 China) Abstract Objective To evaluate the diagnostic value of procalcitonin for early detection of septicemia of newborn. Methods Information concerning the use of procalcitonin for early detection of septicemia was collected from CNKI and VIP database. Two different standards were used in this study. The quality of the studies was assessed using the QUADAS tool. Heterogeneity sensitivity specificity positive likelihood ratio negative likelihood ratio and the area under the SROC (AUC) were analyzed by the software of Metadisc1.4 and Review Manager5. Results According to the Standard One eight studies were included in the analysis and there was no significant difference among these 8 studies (χ =3.8P=0.858I =0.0%). In these eight studies the pooled sensitivity was 0.914 pooled specificity was 0.935 and the area under the SROC was 0.9783. According to the Standard Two seven studies were included in the analysis and there was no significant difference among these 7 studies (χ =3.4P=0.779I =0.0%). In these seven studies the pooled sensitivity was 0.876 pooled specificity was 0.943 and the area under the SROC was 0.9578. Conclusion In this systematic review the diagnostic value of the procalcitonin is high and it can be a good indicator for the early diagnosis of the septicemia of newborn. Key words procalcitonin; newborn; septicemia; systematic review [1-3] C (C- reactive proteincrp) [ 4 ] ( procalcitonin :(1983-) : * : E-mail: yongyurui@tom. com PCT)199 [5] (CT)N [6 ] [7] (~3 h ) PCT 0~4 h

009 3 9 3 57 PCT (SROC) 1.7 [10] MetaDiSc1.4 (DOR) 0.1I 1 I <5% 5% I 50% I [11] >50% ; ( ) () Moses Review Manager5 Meta Meta 1.1 1.1.1 1 PCT 97 [61-18] ; 8 (1) 1 ( 8 d ); 3 1987 1988 ( ) ( ) 1.1. 1 3 ( ) 1. 1..1 (n=44) 1 ; ;3 : : (n=37) 1.. 1 3 : (n=7) 1.3 (CNKI) (1999.1~ 008.4) ( )(VIP)(1989.1~ Fig.1 008.4) : PCT. 8 [1 17] : ( PCT ) ( 6 [613-1618] ) 8 1.4 1 1988.1 NCKI VIP (n=97) (n=53) (n=36) : (n=8) PCT [6 1-18] 8 1987 [61-18] 8 1.5 QUADAS (quality assessment [61-18] 8 8 [61-18] 8 of diagnostic accuracy studies) 8..1 6 (4-710- [89] 1) 4-7 10 100% 1.6 11 1 1 The screening process of the including studies

58 Journal of Tropical Medicine Vol.9 No.3 Mar.009 Tab.1 1 8 () The characteristics of included studies (standard one) 007 [6] 006 [1] 004 [13] 003 [14] 007 [15] 005 [16] 004 [17] 004 [18] (ng / ml) DOR (TP) (FP) (FN) (TN) PCT-Q BRAHMS 76 44 0 1 0 0.79 1.00 145.96 PCT-Q BRAHMS 71 39 0 6 6 0.87 1.00 3.08 PCT-Q BRAHMS 85 43 7 33 0.86 0.94 101.36 PCT-Q BRAHMS 63 37 0 6 0 0.86 1.00 36.54 PCT-Q BRAHMS 16 81 9 4 68 0.95 0.88 153.00 PCT-Q BRAHMS 146 108 4 0 34 1.00 0.89 1663.70 PCT-Q BRAHMS 98 19 4 1 74 0.95 0.95 351.50 PCT-Q BRAHMS 50 3 1 15 0.94 0.94 40.00 :PCT-Q 14. 13. 1. 11. 10. 9. 8. 7. 6. 5. 4. 3.. 1. Fig. 0.3 100% 0. 0.1.. (1) 1 33.3%66.7% 100%..3 3 (8913) 8 9 100% 13 100%.4 Meta.3 Meta.3.1 8 [61-1419-1] 7 1 8 ()QUADAS Quality assessment results of the 8 studies(standard one) by QUADAS.3. 8 ) (χ =3.8P=0.858I =0.0% ) DOR 09.54 [95% CI (100.96434.93)] Meta 7 (χ =3.4P=0.779I = 0.914 [95% CI (0.8840.938)] 0.094 [95%CI (0.0680.19)] (χ =.91P=0.00I =69.5% );SROC (AUC) 0.9783SE(AUC)=0.0063(3) DOR (χ =34.74P=0.000I =79.9%); 0.876 [95% CI 0.935 [95%CI (0.900.960)] (0.8180.90)] 0.943 [95% CI (0.900 (χ =1.83P=0.076I =45.4%); 0.971)] 1.79[95%CI(7.4991.606)] 1.693 [95%CI (8.30919.391)] 0.148 [95%CI (0.100.14)]AUC (χ =5.30P =0.64I =0.0% ); 0.9578SE(AUC)=0.0151(4) 1 Sensitivity 1.0 0.9 0.8 0.7 0.6 0.4 SROC Curve 0 0 0. 0.4 0.6 0.8 1.0 1-specificity 3 8 ()SROC Fig.3 SROC for the 8 studies (standard one) 7 ( 7 Meta 0.0%) DOR 96.4 Symmetric SROC AUC = 0.9783 SE (AUC ) = 0.0063 Q * = 0.9341 SE (Q * ) = 0.0115 [95% CI(46.11401.61)]

009 3 9 3 59 Tab. 7 () The characteristics of included studies (standard two) 007 [6] 006 [1] 004 [13] 003 [14] 006 [19] 005 [0] 003 [1] (ng / ml) DOR (TP) (FP) (FN) (TN) PCT-Q BRAHMS PCT-Q BRAHMS 46 43 4 15 0 0 0 6 0.9 0.88 1.00 1.00 401.80 38.60 PCT-Q BRAHMS 65 4 6 33 0.80 0.94 66.00 PCT-Q BRAHMS 36 15 0 1 0 0.94 1.00 43.67 PCT-Q BRAHMS 64 37 4 1 0.95 0.84 97.13 Diagnostica 58 18 5 33 0.78 0.94 59.40 BRAHMS 58 3 4 9 0.85 0.91 53.17 :PCT-Q Sensitivity SROC Curve 1.0 Symmetric SROC 0.9 AUC = 0.9578 SE (AUC ) = 0.0151 0.8 0.7 Q * = 0.9013 SE (Q * ) = 0.016 0.6 0.4 0.3 0. 0.1 0 0 0. 0.4 0.6 0.8 1.0 3 1-specificity 4 7 ()SROC Fig.4 SROC for the 7 studies (standard two) 0.914 0.935 AUC 0.9783 ( 3); CRP ; 0.876 0.943AUC 0.9578(4) CRP CRP [] : ; PCT ( ) ( ) () PCT PCT PCT AUC PCT [5] ; 3 3. PCT DOR SROC PCT 8 0.914 0.935 1.693 0.094AUC 0.9783 PCT PCT PCT PCT PCT PCT 3.3 Meta 3.1 6 8 Meta PCT 3.4 ; PCT ;

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