The Diagnostic Value Of Fecal Lactoferrin In Evaluating Disease Activity Of Inflammatory Bowel Disease:A Systematic Review And Meta-analysis

Objective The aim of this meta-analysis is to search all relevant literatures to explore the diagnostic value of fecal lactoferrin in evaluating disease activity of inflammatory bowel disease.Methods CNKI(China National Knowledge Infrastructure), Wanfang database, VIP database, Pubmed, EMSASE, and Cochrane library were searched systematically for studies which evaluated the diagnostic ability of FL between active and inactive IBD patients up to October 2015. The main effect sizes of diagnostic trails were pooled sensitivity(Se), specificity(Sp), diagnostic odds ratio(DOR) and other diagnostic indexes. The heterogeneity was evaluated by a chi-square test(?2) or Q-statistic and I-squared statistic(I2). Fixed effect model was used for the data analysis when p?0.05, otherwise, random effect model was selected. The publication bias of this meta-analysisi was detected by Deek's funnel plots. Statistic analyses were performed on Review Manager(Rev Man)(version 5.3), Meta-Disc(version 1.4) and Stata software(version 12).Results Finally, 11 eligible studies(n=737, including 361 with UC and 376 with CD) were included. The meta-analysis suggested that FL is a reliable noninvasive marker to assess the IBD activity. The results of statistic analyses are shown as follows:(1) The pooled Se, Sp, and DOR in the UC group are higher that these in the CD group. In the UC group, the pooled Se, Sp, and DOR is 0.89(95%CI, 0.84-0.92), 0.75(0.67-0.81) and 24.71(10.14-60.23), respectively. In the CD group, these diagnostic indexes are 0.83(0.78-0.88), 0.63(0.55-0.70), 10.1(4.87-20.97), respectively.(2) The pooled positive likelihood ratio(PLR) and pooled negative likelihood ratio(NLR) in the UC group are superior to these in the CD group(3.46 versus 2.07,0.17 versus 0.31, respectively).(3) The areas under the curve values(AUC) of the summary receiver operating characteristic curve(s ROC) are 0.9261 and 0.8429 in the UC and CD group.Conclusions FL is a noninvasive reliable desirable biomarker to assess the IBD activity with a greater diagnostic ability in UC than in CD.