Meta analysis on serum IgG4 in the diagnosis of autoimmune pancreatitis by nephelometry

doi:10.3969/j.issn.1673-8640.2015.11.017

Abstract

Abstract: Objective

Meta analysis was used to evaluate the diagnostic significance of serum IgG4 by nephelometry for autoimmune pancreatitis (AIP).

Methods

By searching Wanfang, CNKI and SinoMed, PubMed, Embase, Web of Science, Scienecdirect, Cochrane from inception to September 22, 2014, combined with additional manual tracking, both English and Chinese literatures about serum IgG4 by nephelometry for the diagnosis of AIP were reviewed. According to the inclusion and exclusion criteria, literatures were selected. Quality assessment was conducted according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Sensitivity, specificity and diagnostic odds ratio (DOR) were pooled, and summary receiver operating characteristic (SROC) curve was drawn by the software Meta-disc 1.4. Publication bias was analyzed by Stata12.0 software.

Results

A total of 12 studies were included. Diagnostic two-by-two table about differentially diagnosing AIP and pancreatic cancer were constructed from 8 studies of the 12 studies. Test for heterogeneity suggested no threshold effect, but there was significant heterogeneity caused by other factors group. The pooled sensitivity and specificity were 73% and 94% for AIP with control group. The pooled sensitivity and specificity were 70% and 92% for AIP with pancreatic cancer. Funnel plots (Deeks) revealed no publication bias, and sensitivity analysis revealed that the results of this meta analysis were stable.

Conclusions

Serum IgG4 by nephelometry is a useful parameter in diagnosing AIP as well as differentiating AIP from pancreatic cancer.

Key words: IgG4, Meta analysis, Autoimmune pancreatitis, Pancreatic cancer

CLC Number:

R446.62

LIAN Mingjian, LIU Dan, LI Dan, LIU Shuye. Meta analysis on serum IgG4 in the diagnosis of autoimmune pancreatitis by nephelometry[J]. Laboratory Medicine, 2015, 30(11): 1131-1137.

Figures/Tables 4

References 24

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作者	年份	区域	临界值 (mg/dL)	诊断标准	AIP	区分AIP与对照组				评分	区分AIP与胰腺癌
作者	年份	区域	临界值 (mg/dL)	诊断标准	AIP	TP		FP	FN	TN	TP	FP	FN	TN
GHAZALE等^[8]	2007	美国	140	HISORt	45	34	33	11	432	15	34	13	11	122
HIRANO等^[9]	2006	日本	135	JPS 2002或长时间观察	35	33	4	2	77	17	33	0	2	23
APARISI等^[10]	2005	西班牙	130	Spanish score	6	4	8	2	169	15	—	—	—	—
UEHARA等^[11]	2005	日本	135	临床经验	6	6	0	0	6	12	—	—	—	—
SONG等^[12]	2009	韩国	135	Asian或 HISORt	82	43	1	39	109	13	43	1	39	109
VAN HEERDE等^[13]	2014	荷兰	140	ICDC, Asian 或 HISORt等	33	28	10	5	43	13	28	10	5	43
SADLER等^[14]	2011	英国	130	HISORt	21	19	15	2	160	15	—	—	—	—
TABATA等^[15]	2009	日本	135	Asian	39	30	45	9	384	15	30	5	9	111
KAJI等^[16]	2011	日本	135	Asian或ICDC	35	32	2	3	69	15	—	—	—	—
鲁琼等^[17]	2011	中国	200	Asian	11	11	17	0	752	15	11	0	0	30
CHANG等^[18]	2014	中国台湾	140	HISORt, Asian或ICDC	188	105	22	57	154	15	105	18	57	72
VAN TOOREN-ENBERGEN等^[19]	2010	荷兰	160	HISORt	13	9	1	4	11	13	9	1	4	11

作者	年份	区域	临界值 (mg/dL)	诊断标准	AIP	区分AIP与对照组				评分	区分AIP与胰腺癌
作者	年份	区域	临界值 (mg/dL)	诊断标准	AIP	TP		FP	FN	TN	TP	FP	FN	TN
GHAZALE等^[8]	2007	美国	140	HISORt	45	34	33	11	432	15	34	13	11	122
HIRANO等^[9]	2006	日本	135	JPS 2002或长时间观察	35	33	4	2	77	17	33	0	2	23
APARISI等^[10]	2005	西班牙	130	Spanish score	6	4	8	2	169	15	—	—	—	—
UEHARA等^[11]	2005	日本	135	临床经验	6	6	0	0	6	12	—	—	—	—
SONG等^[12]	2009	韩国	135	Asian或 HISORt	82	43	1	39	109	13	43	1	39	109
VAN HEERDE等^[13]	2014	荷兰	140	ICDC, Asian 或 HISORt等	33	28	10	5	43	13	28	10	5	43
SADLER等^[14]	2011	英国	130	HISORt	21	19	15	2	160	15	—	—	—	—
TABATA等^[15]	2009	日本	135	Asian	39	30	45	9	384	15	30	5	9	111
KAJI等^[16]	2011	日本	135	Asian或ICDC	35	32	2	3	69	15	—	—	—	—
鲁琼等^[17]	2011	中国	200	Asian	11	11	17	0	752	15	11	0	0	30
CHANG等^[18]	2014	中国台湾	140	HISORt, Asian或ICDC	188	105	22	57	154	15	105	18	57	72
VAN TOOREN-ENBERGEN等^[19]	2010	荷兰	160	HISORt	13	9	1	4	11	13	9	1	4	11

组别	篇数	合并敏感性[95%CI,I²(%)]	合并特异性[95%CI,I²(%)]	DOR[95%CI,I²(%)]	AUC
区分AIP与对照组	12	0.73(0.68~0.76,80.70)	0.94(0.93~0.95,84.80)	58.34(29.00~117.33,68.30)	0.949
区分AIP与胰腺癌	8	0.70(0.65~0.74,82.30)	0.92(0.89~0.94,83.60)	43.42(15.98~117.96,75.50)	0.894
区域
亚洲	7	0.70(0.65~0.75,87.70)	0.94(0.93~0.96,89.70)	98.17(28.49~338.25,81.00)	0.969
非亚洲	5	0.80(0.71~0.87,4.20)	0.92(0.90~0.94,60.70)	38.95(22.61~67.08,0.00)	0.926
研究年份
2010年以前	6	0.70(0.64~0.76,83.40)	0.93(0.91~0.94,75.10)	55.20(26.88~113.35,37.10)	0.948
2010年及以后	6	0.74(0.69~0.79,80.90)	0.95(0.93~0.96,89.70)	61.99(17.49~219.72,78.40)	0.955
AIP研究例数
>20例	8	0.72(0.67~0.76,84.70)	0.92 (0.90~0.93,77.00)	53.14(24.35~115.97,75.20)	0.941
≤20例	4	0.83(0.67~0.94,65.70)	0.97(0.96~0.98,22.70)	78.62(22.60~273.67,33.10)	0.989
疾病谱
疾病谱全	7	0.76(0.71~0.80,82.00)	0.94(0.93~0.95,88.50)	73.08(27.59~193.53,81.20)	0.983
疾病谱不全	5	0.64(0.56~0.72,76.80)	0.94(0.92~0.97,79.40)	46.75(20.50~106.61,0.00)	0.906

组别	篇数	合并敏感性[95%CI,I²(%)]	合并特异性[95%CI,I²(%)]	DOR[95%CI,I²(%)]	AUC
区分AIP与对照组	12	0.73(0.68~0.76,80.70)	0.94(0.93~0.95,84.80)	58.34(29.00~117.33,68.30)	0.949
区分AIP与胰腺癌	8	0.70(0.65~0.74,82.30)	0.92(0.89~0.94,83.60)	43.42(15.98~117.96,75.50)	0.894
区域
亚洲	7	0.70(0.65~0.75,87.70)	0.94(0.93~0.96,89.70)	98.17(28.49~338.25,81.00)	0.969
非亚洲	5	0.80(0.71~0.87,4.20)	0.92(0.90~0.94,60.70)	38.95(22.61~67.08,0.00)	0.926
研究年份
2010年以前	6	0.70(0.64~0.76,83.40)	0.93(0.91~0.94,75.10)	55.20(26.88~113.35,37.10)	0.948
2010年及以后	6	0.74(0.69~0.79,80.90)	0.95(0.93~0.96,89.70)	61.99(17.49~219.72,78.40)	0.955
AIP研究例数
>20例	8	0.72(0.67~0.76,84.70)	0.92 (0.90~0.93,77.00)	53.14(24.35~115.97,75.20)	0.941
≤20例	4	0.83(0.67~0.94,65.70)	0.97(0.96~0.98,22.70)	78.62(22.60~273.67,33.10)	0.989
疾病谱
疾病谱全	7	0.76(0.71~0.80,82.00)	0.94(0.93~0.95,88.50)	73.08(27.59~193.53,81.20)	0.983
疾病谱不全	5	0.64(0.56~0.72,76.80)	0.94(0.92~0.97,79.40)	46.75(20.50~106.61,0.00)	0.906