Serum anti-PLA2R antibody as a diagnostic biomarker of idiopathic membranous nephropathy: The optimal cut-off value for Chinese patients
Serum anti-PLA2R antibody as a diagnostic biomarker of idiopathic membranous nephropathy: The optimal cut-off value for Chinese patients
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血清抗PLA2R抗体作为特发性膜性肾病的诊断生物标志物：中国患者的最佳临界值
DOI：
10.1016/j.cca.2017.11.006
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发表时间：
2018-01-01
影响因子：
5
通讯作者：
Xu, Dongmei
中科院分区：
文献类型：
--
作者：
Liu, Yipeng;Li, Xuan;Xu, Dongmei
背景：M型磷脂酶A2受体(PLA2R)是特发性膜性肾病(IMN)中发现的一种特异性自身抗原。抗PLA2R自身抗体(抗PLA2R)可用于IMN的诊断。方法：选择2011年9月至2016年3月在千佛山医院接受肾活检的患者119例(IMN患者57例，非IMN患者62例)和22例健康人作为观察对象。用定量酶联免疫吸附试验(ELISA)检测血清抗PLA2R浓度。结果：抗PLA2R抗体诊断IMN的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为82.5、75、69.1和86.3%，2.6RU/ml临界值分别为78.9、91.7、86.5和86.5%；以14RU/ml为临界值，分别为59.6%、95.2、89.5和77.7%；以20RU/ml为临界值，分别为50.9、96.4、90.6和74.3%；以40RU/ml为临界值，分别为47.4、97.6、93.1和73.2%。ROC曲线下面积为0.879。结论：抗PLA2R抗体诊断IMN的临界值为2.6RU/ml。
Background: The M-type phospholipase A2 receptor (PLA2R) is a specific target autoantigen identified in idiopathic membranous nephropathy (IMN). The autoantibody against PLA2R (anti-PLA2R) may be used to diagnose IMN. However, the appropriate diagnosis cut-off value for Chinese patients with IMN has not been established.Methods: In total, 119 patients who underwent renal biopsy (57 patients with IMN and 62 patients with non-IMN glomerulonephritis) and 22 healthy individuals were recruited for our observation study from Qianfoshan Hospital between September 2011 and March 2016. The serum concentration of anti-PLA2R was measured using a quantitative enzyme-linked immunosorbent assay (ELISA). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve of anti-PLA2R in diagnosing IMN were analysed based on the ELISA detection.Results: The sensitivity, specificity, PPV, and NPV of anti-PLA2R in the diagnosis of IMN in the Chinese patients were 82.5, 75, 69.1, and 86.3% for the 2 RU/ml cut-off value; 78.9, 91.7, 86.5, and 86.5% for the 2.6 RU/ml cutoff value; 59.6, 95.2, 89.5, and 77.7% for the 14 RU/ml cut-off value; 50.9, 96.4, 90.6, and 74.3% for the 20 RU/ml cut-off value; and 47.4, 97.6, 93.1, and 73.2% for the 40 RU/ml cut-off value, respectively. The area under the ROC curve was 0.879.Conclusions: The cut-off value of 2.6 RU/ml is recommended for the use of anti-PLA2R for the diagnosis of IMN in Chinese patients based on the ELISA.