Serum CA-125 for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis

Pulmonary tuberculosis (PTB) remains the world's deadliest infectious killer. Serum CA-125 test are useful in the diagnosis of PTB. Although studies on the relation between CA-125 and PTB have been reported, the specificity and sensitivity of serum CA-125 in diagnosing PTB vary widely among different studies. The present study was performed to evaluate the accuracy of CA-125 for the diagnosis of PTB via a meta-analysis of data obtained from previous studies.

English and Chinese medical electronic databases were searched for eligible studies published up to February 2020. STATA software was used to obtain a pooled estimation of the diagnostic accuracy of CA-125 and analyze the heterogeneity of the recruited studies. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of the obtained studies.

A total of 16 articles were included in this study. The pooled sensitivity and specificity of CA-125 were 0.85 [95% confidence interval (CI) 0.75-0.91] and 0.87 (95% CI 0.78-0.93), respectively. Moreover, the pooled positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) of CA-125 were 6.65 (95% CI 3.62-12.20), 0.18 (95% CI 0.10-0.31), and 37.82 (95% CI 13.17-108.60), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.93.

Taken together, the results indicate that serum CA-125 presents potential practical value for diagnosing PTB, but its clinical applicability must be further examined.