An update on clinical significance of use of THSD7A in diagnosing idiopathic membranous nephropathy: a systematic review and meta-analysis of THSD7A in IMN.
An update on clinical significance of use of THSD7A in diagnosing idiopathic membranous nephropathy: a systematic review and meta-analysis of THSD7A in IMN.
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DOI：
10.1080/0886022x.2018.1456457
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发表时间：
2018-11
期刊：
影响因子：
3
通讯作者：
Hong D
中科院分区：
文献类型：
--
作者：
Ren S;Wu C;Zhang Y;Wang AY;Li G;Wang L;Hong D
背景：THSD 7A是特发性膜性肾病（IMN）的新靶抗原。此外，恶性肿瘤也见于THSD 7A阳性膜性肾病患者。我们的目的是系统地评估THSD 7A在IMN患者中的患病率和THSD 7A阳性患者中的恶性肿瘤。方法：我们检索英文和中文数据库，检索日期为2017年12月31日，检索词为“THSD 7A”或“含凝血酶敏感蛋白1型结构域7A”。采用Meta分析方法，对THSD 7A在IMN患者中的阳性率进行分析。根据THSD 7A的种族、样本量和检测方法进行亚组分析。结果：最终纳入了10项研究，涉及4121名受试者。所有患者中THSD 7A的患病率为3%（95% CI，3%-4%），PLA 2 R阴性患者中为10%（95% CI，6%-15%）。77例患者循环抗体阳性，THSD 7A的患病率也较低，为3%（95%CI，2%-4%）。总体而言，72例患者在肾活检中具有阳性THSD 7A染色，患病率为3%（95%CI 2%-4%）。亚组分析显示，基于研究样本量，THSD 7A的患病率存在显著差异，但不同种族之间未观察到显著差异。此外，在THSD 7A阳性患者中，3/10项研究报告了恶性肿瘤，发生率从6%到25%不等。结论：THSD 7A在PLA 2 R阴性患者中的患病率高于IMN患者。建议在THSD 7A阳性MN患者中筛查恶性肿瘤。
Background: THSD7A is a new target antigen of idiopathic membranous nephropathy (IMN). Moreover, malignancies are also found in patients with THSD7A-positive membranous nephropathy. We aimed to systematically evaluate the prevalence of THSD7A in IMN patients and malignancies in THSD7A-positive patients. Methods: We searched English and Chinese database to 31 December 2017 with the term ‘THSD7A’ or ‘thrombospondin type 1 domain-containing 7A’. Meta-analysis was used to explore the positive rate of THSD7A in the IMN patients. Subgroup analysis was performed according to the race, sample size, and detecting method of THSD7A. Results: Ten studies involving 4121 participants were eventually included. The prevalence of THSD7A was 3% (95% CI, 3%–4%) in all patients and 10% (95% CI, 6%–15%) in PLA2R-negative patients. 77 patients had positive circulating antibodies, and the prevalence of THSD7A was also low at 3% (95% CI, 2%–4%). Overall, 72 patients had positive THSD7A staining on renal biopsy, and the prevalence was 3% (95% CI 2%–4%). Subgroup analysis showed significant differences in the prevalence of THSD7A based on the study sample sizes, however, no significant differences were seen in different ethnic groups. Furthermore, among THSD7A-positive patients, 3/10 studies reported malignancies with the incidence varied from 6% to 25%. Conclusions: The prevalence of THSD7A is more common in the PLA2R-negative patients than the IMN patients. Screening for malignancies in THSD7A-positive MN patients is recommended.