Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Jun;8:302-308.
doi: 10.1016/j.ebiom.2016.04.024. Epub 2016 Apr 21.

Diagnostic Performance of Bronchoalveolar Lavage Fluid CD4/CD8 Ratio for Sarcoidosis: A Meta-analysis

Affiliations
Free PMC article
Meta-Analysis

Diagnostic Performance of Bronchoalveolar Lavage Fluid CD4/CD8 Ratio for Sarcoidosis: A Meta-analysis

Yongchun Shen et al. EBioMedicine. .
Free PMC article

Abstract

Background: The usefulness of bronchoalveolar lavage fluid (BALF) CD4/CD8 ratio for diagnosing sarcoidosis has been reported in many studies with variable results. Therefore, we performed a meta-analysis to estimate the overall diagnostic accuracy of BALF CD4/CD8 ratio based on the bulk of published evidence.

Methods: Studies published prior to June 2015 and indexed in PubMed, OVID, Web of Science, Scopus and other databases were evaluated for inclusion. Data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled from included studies. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deeks's funnel plot was used to detect publication bias.

Results: Sixteen publications with 1885 subjects met our inclusion criteria and were included in this meta-analysis. Summary estimates of the diagnostic performance of the BALF CD4/CD8 ratio were as follows: sensitivity, 0.70 (95%CI 0.64-0.75); specificity, 0.83 (95%CI 0.78-0.86); PLR, 4.04 (95%CI 3.13-5.20); NLR, 0.36 (95%CI 0.30-0.44); and DOR, 11.17 (95%CI 7.31-17.07). The area under the SROC curve was 0.84 (95%CI 0.81-0.87). There was no evidence of publication bias.

Conclusion: Measuring the BALF CD4/CD8 ratio may assist in the diagnosis of sarcoidosis when interpreted in parallel with other diagnostic factors.

Keywords: Bronchoalveolar lavage fluid; CD4/CD8 ratio; Meta-analysis; Sarcoidosis.

Figures

Fig. 1
Fig. 1
Study selection. BALF = Bronchoalveolar lavage fluid.
Fig. 2
Fig. 2
Quality assessment of individual studies in terms of risk of bias and applicability concerns based on the Quality Assessment of Diagnostic Accuracy Studies-2.
Fig. 3
Fig. 3
Forest plot of the summary sensitivity and specificity of BALF CD4/CD8 ratio for the diagnosis of sarcoidosis. The sensitivity/specificity of each study is represented as a circle, and the 95%CI is shown as a horizontal line running through the circle. TP = true positive. FP = false positive. FN = false negative. TN = true negative. BALF = bronchoalveolar lavage fluid.
Fig. 4
Fig. 4
Summary receiver operating characteristic (SROC) curve of BALF CD4/CD8 ratio for the diagnosis of sarcoidosis. Each open circle is the result of a single study. BALF = bronchoalveolar lavage fluid.
Fig. 5
Fig. 5
Funnel plots for assessing the risk of publication bias. The funnel graph shows the log of the diagnostic odds ratio (DOR) plotted against the standard error of the log of the DOR (an indicator of sample size). Solid circles represent each study in the meta-analysis. The line indicates the regression result.

Comment in

Similar articles

See all similar articles

Cited by 7 articles

See all "Cited by" articles

References

    1. Agarwal R., Srinivasan A., Aggarwal A.N., Gupta D. Efficacy and safety of convex probe EBUS-TBNA in sarcoidosis: a systematic review and meta-analysis. Respir. Med. 2012;106:883–892. - PubMed
    1. American Thoracic Society: European Respiratory Society World association of sarcoidosis and other granulomatous disorders Statement on sarcoidosis. Am. J. Respir. Crit. Care Med. 1999;160:736–755. - PubMed
    1. Baughman R.P., Grutters J.C. New treatment strategies for pulmonary sarcoidosis: antimetabolites, biological drugs, and other treatment approaches. Lancet Respir. Med. 2015;3:813–822. - PubMed
    1. Baughman R.P., Lower E.E., du Bois R.M. Sarcoidosis. Lancet. 2003;361:1111–1118. - PubMed
    1. Baughman R.P., Culver D.A., Judson M.A. A concise review of pulmonary sarcoidosis. Am. J. Respir. Crit. Care Med. 2011;183:573–581. - PMC - PubMed

Publication types

Feedback