{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:53:36Z","timestamp":1773276816874,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"unspecified","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Nanjing Incubation Program for National Clinical Research Center","award":["2019060001"],"award-info":[{"award-number":["2019060001"]}]},{"name":"CAMS","award":["CIFMS-2021-I2M-1-001"],"award-info":[{"award-number":["CIFMS-2021-I2M-1-001"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601804"],"award-info":[{"award-number":["81601804"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772209"],"award-info":[{"award-number":["81772209"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Special Research Fund for Central Universities, Peking Union Medical College","award":["3332023077"],"award-info":[{"award-number":["3332023077"]}]},{"name":"Jiangsu Provincial Double Innovation Doctor Project","award":["JSSCBS20221929"],"award-info":[{"award-number":["JSSCBS20221929"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,5,20]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically assess the diagnostic accuracy of CXCL13 testing of cerebrospinal fluid (CSF) for neurosyphilis diagnosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, Embase, Cochrane Library and Web of Science databases from their inception until 1 May 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Both cross-sectional and case\u2013control diagnostic test studies evaluating the diagnostic value of CSF CXCL13 in diagnosing neurosyphilis were included, with no language restrictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two researchers extracted data independently from all finally included articles. The updated Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of the included studies. Quantitative synthesis was done using a bivariate random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This meta-analysis included seven eligible studies involving a total of 1152 patients with syphilis and 430 patients with neurosyphilis. The pooled sensitivity, specificity and summary area under the curve (AUC) of CSF CXCL13 testing for the diagnosis of neurosyphilis were 0.76 (95% CI 0.64 to 0.85; I\n                      <jats:sup>2<\/jats:sup>\n                      =82%), 0.83 (95% CI 0.80 to 0.85; I\n                      <jats:sup>2<\/jats:sup>\n                      =32.29%) and 0.84 (95% CI 0.81 to 0.87), respectively. Sensitivity analysis confirmed the stability of the combined results. Meta-regression analysis revealed that the heterogeneity of pooled sensitivity was related to different study regions; subgroup analysis indicated that the diagnostic value of CSF CXCL13 testing reported in studies from China was superior to that reported in non-Chinese studies (pooled sensitivity, specificity and summary AUC values were 0.84\n                      <jats:italic>(<\/jats:italic>\n                      I\n                      <jats:sup>2<\/jats:sup>\n                      =0) vs 0.64 (I\n                      <jats:sup>2<\/jats:sup>\n                      =79.53%), 0.83 (I\n                      <jats:sup>2<\/jats:sup>\n                      =42.03%) vs 0.83 (I\n                      <jats:sup>2<\/jats:sup>\n                      =32.87%) and 0.87 vs 0.83, respectively). The diagnostic value reported in studies with a sample size \u2265200, unclassified neurosyphilis and HIV-negative subgroups was superior to the total combined value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis has demonstrated a reasonable level of accuracy for diagnosis of neurosyphilis with CSF CXCL13 testing. Further multicentre, prospective diagnostic studies, especially in asymptomatic neurosyphilis and HIV-infected patients, are needed to provide more evidence for evaluation before clinical application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023414212.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078527","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T12:01:12Z","timestamp":1718366472000},"page":"e078527","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"given":"Fang-Zhi","family":"Du","sequence":"first","affiliation":[{"name":"Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Li","family":"Zheng","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui-Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-3826","authenticated-orcid":false,"given":"Qian-Qiu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Prevention and Control of STD, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"2025121407255402000_14.5.e078527.1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.33588\/rn.6902.2018381","article-title":"Clinical and socio-demographic profile of Neurosyphilis: a retrospective study in a reference centre in Colombia","volume":"69","author":"Quintero-Moreno","year":"2019","journal-title":"Rev Neurol"},{"key":"2025121407255402000_14.5.e078527.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0238617","article-title":"Neurosyphilis: still prevalent and overlooked in an at risk population","volume":"15","author":"Ramachandran","year":"2020","journal-title":"PLoS One"},{"key":"2025121407255402000_14.5.e078527.3","doi-asserted-by":"crossref","DOI":"10.1038\/srep45339","article-title":"Late Neurosyphilis and tertiary Syphilis in Guangdong province, China: results from a cross-sectional study","volume":"7","author":"Tang","year":"2017","journal-title":"Sci Rep"},{"key":"2025121407255402000_14.5.e078527.4","unstructured":"Tan X . 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