Systematic Review and Meta-Analysis: Accuracy of Both Gamma Delta+ Intraepithelial Lymphocytes and Coeliac Lymphogram Evaluated by Flow Cytometry for Coeliac Disease Diagnosis.

ABSTRACT: It has been suggested that in doubtful cases of coeliac disease, a high CD3⁺ T-cell receptor gamma delta⁺ (TCRγδ⁺) intraepithelial lymphocyte count increases the likelihood of coeliac disease.

Aim

To evaluate the diagnostic accuracy of both an isolated increase of TCRγδ⁺ cells and a coeliac lymphogram (increase of TCRγδ⁺ plus decrease of CD3^- intraepithelial lymphocytes) evaluated by flow cytometry in the diagnosis of coeliac disease.

Methods

The literature search was conducted in MEDLINE and EMBASE. The inclusion criteria were: an article that allows for the construction of a 2 × 2 table of true and false positive and true and false negative values. A diagnostic accuracy test meta-analysis was performed.

Results

The search provided 49 relevant citations, of which 6 were selected for the analysis, which represented 519 patients and 440 controls. Coeliac lymphogram: The pooled S and Sp were 93% and 98%, without heterogeneity. The area under the SROC curve (AUC) was 0.98 (95% CI, 0.97-0.99). TCRγδ⁺: Pooled S and Sp were both 95%, with significant heterogeneity. The AUC was 0.97 (95% CI, 0.95-0.98). Conclusions: Both TCRγδ⁺ count and coeliac lymphogram assessed by flow cytometry in duodenal mucosal samples are associated with a high level of diagnostic accuracy for and against coeliac disease.

SUBMITTER: Fernandez-Banares F 

PROVIDER: S-EPMC6769802 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature