To evaluate the diagnostic value of ELISA detection of serum immune antigens for hydatid disease.

Literature search related to ELISA detection of serum immune antigens in hydatid disease was conducted in PubMed, Cochrane Library, CNKI and Wanfang Data from the inception date of databases to February 1, 2021. The searching terms included serological diagnosis, hydatid disease, hydatidosis and antigen in both Chinese and English. The literature screening was performed by two reviewers according to the inclusion and exclusion criteria, and required data were extracted. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to assess each study's methodological quality. The summary receiver operating characteristic (SROC) curve was adopted to evaluate the threshold effect of diagnostic test.

20 articles were eventually included, including2 032 cases of hydatid disease diagnosed by gold standard criteria, 1 521 resembling cases and 1 824 healthy individuals. The diagnostic results of total serum immune antigen showed that the area under SROC curve was 0.94. Considering the non-threshold effect, Meta-analysis was conducted by using random effect model. The pooled sensitivity was 0.84, the pooled specificity was 0.81, the pooled positive likelihood ratio was 7.41, the pooled negative likelihood ratio was 0.16, and the pooled diagnostic odds ratio was 50.45, respectively. The pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of HCF antigen diagnostic test were 0.92, 0.84, 7.87 and 0.10, and 0.82, 0.80, 10.09 and 0.16 for AgB antigen, and 0.86, 0.79, 4.14 and 0.15 for Eg antigen, and 0.74, 0.93, 8.86 and 0.20 for Em antigen, and 0.84, 0.81, 2.72 and 0.12 for H3 antigen, respectively.

ELISA detection of serum immune antigens yields high sensitivity and specificity in the diagnosis of hydatid disease, among which HCF and AgB antigens possess higher diagnostic value.