血清抗PLA2R抗体检测对特发性膜性肾病诊断效能的meta分析

Diagnostic value of serum PLA2R antibody detection for idiopathic membranous nephropathy: A meta-analysis

目的利用meta分析评估血清抗M型磷脂酶A2受体(M-type phospholipase A2 receptor,PLA2R)抗体检测对特发性膜性肾病(IMN)的诊断效能。方法检索Pub Med、Embase、万方和中国知网,从建库到2017年5月关于血清抗PLA2R抗体检测诊断IMN的相关中英文文献。严格地按照制定的纳入和排除标准筛选文献,采用QUADAS进行文献质量评价。采用Metadisc 1.4进行异质性分析和效应量合并,采用Stata 12.0进行发表偏倚评估。结果 20篇文献纳入研究,文献质量较好,异质性检验提示不存在阈值效应。合并敏感性为0.69(95%CI:0.67~0.72),合并特异性为0.97(95%CI:0.96~0.98),合并曲线下面积为0.880。敏感性分析提示结果稳定,Deek漏斗图提示不存在发表偏倚。结论血清抗PLA2R抗体检测对IMN诊断具有可接受的敏感性和较高的特异性,应该受到临床的重视。

Objective To evaluate the diagnostic value of serum M-type phospholipase A2 receptor（ PLA2R） antibody detection for the diagnosis of idiopathic membranous nephropathy（ IMN） by meta analysis. Methods By searching the databases of Pub Med,Emabse,Wanfang and CNKI from inception to May,2017,all the literatures referred to serum PLA2 R antibody for the diagnosis of IMN in both English and Chinese were reviewed and selected according to the inclusion and exclusion criteria. QUADAS was used to assess the quality of eligible studies. Meta-disc 1. 4 was used to analyze heterogeneity and pooled effectsize and Stata 12. 0 was used to analyze publication bias. Results A total of 20 studies with high quality were included. Heterogeneity test indicated there was no threshold effect. The pooled sensitivity was 0. 69（ 95% CI： 0. 67 to 0. 72）,the pooled specificity was 0. 97（ 95% CI： 0. 96 to 0. 98） and the summary area under curve was 0. 880. Sensitivity analysis indicated that the result was stable. Deek＇s funnel plot indicated there was no publication bias. Conclusion The sensitivity of detection of serum PLA2R antibody was acceptable for the diagnosis of IMN with high specificity,so more attention on PLA2 R antibody should be paid in the clinical practice.