ELISA与FACS定量方法检测血清AQP4抗体诊断NMO的Meta分析  

Quantitative detection of aquaporin-4 antibody in serum by ELISA and FACS in the diagnosis of neuromyelitis optica:A meta-analysis

作　　者：杨彬彬[1] 孙艳霞[1] 刘磊[2] 孙林[2] 代飞飞[2] 王佳伟[1,2] 

机构地区：[1]首都医科大学附属北京同仁医院中心实验室,100730 [2]首都医科大学附属北京同仁医院神经内科,100730

出　　处：《中国神经免疫学和神经病学杂志》2016年第5期344-350,共7页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的 系统评价酶联免疫吸附试验（ELISA）、流式细胞术（FACS）检测血清水通道蛋白4抗体（AQP4-IgG）对诊断视神经脊髓炎（NMO）的准确性。方法 检索国内外公开发表的相关文献。根据题目、摘要、全文逐步筛选,采用质量评价工具（QUADAS）分析文献质量。采用Meta-Disc1.4与STATA 12.0软件进行Meta分析。根据Meta分析结果综合评价ELISA和FACS方法诊断NMO的准确性。结果 经过严格的纳入及排除标准,最终纳入17篇文献。ELISA和FACS方法合并敏感度分别为0.63（95%CI：0.58～0.68）和0.55（95%CI：0.48～0.61）,合并特异度分别为0.98（95%CI：0.97～0.98）和0.99（95%CI：0.98～0.99）。拟合受试者工作特征曲线（SROC）,得到SROC曲线下面积（AUC）分别为0.9521和0.9542。结论通过ELISA和FACS方法检测AQP-4-IgG对于诊断NMO特异度高,两者都具有较高的诊断效能和准确率。但受纳入研究质量和数量限制,两种方法诊断效能的一致性尚需开展更多高质量研究予以验证。Objective To systematically review the diagnostic accuracy for neuromyelitis optica （NMO） depending on detection of aquaporin‐4 （AQP‐4 ） antibody in serum by enzyme‐linked immunosorbent assay （ELISA） and flow cytometry （FACS ） . Methods _ A search of major digital database and hand search of references were conducted. All published studies relating to the detection of AQP‐4 antibody in serum by ELISA and FACS for patients with NMO were retrieved. Two reviewers independently and stepwisely screened the literature according to the titles ,abstracts and the full texts ,extracted data ,and methodological quality of included studies was assessed by QUADAS. Meta‐analysis was then conducted using Meta‐Disc 1.4 and STATA 12.0 software. The overall sensitivity and specificity of ELISA and FACS were pooled separately and compared with overall accuracy measure：summary receiver operating characteristic curve （SROC ） . Results _ After applying the inclusion and exclusion criteria ,17 studies were included in this systematic review and meta‐analysis. The results of meta‐analysis showed：the pooled sensitivity of ELISA was 0.63 （95% CI：0.58‐0.68） and FACS 0.55 （95% CI：0.48‐0.61） ,the pooled specificity of ELISA was 0.98 （95% CI：0.97‐0.98） and FACS 0.99 （95% CI：0.98‐0.99） . The AUCs for ELISA and FACS were similar （0.9521 and 0.9542 , respectively） . Conclusions AQP4 detection in serum with ELISA or FACS is a useful tool for the diagnosis of patients with NMO ,due to high specificity and excellent AUC results. However ,due to limited quality and quantity of the included studies ,more well‐conducted studies are needed to verify the consistency of diagnostic efficacy between two methods.

关 键 词：视神经脊髓炎 水通道蛋白4 酶联免疫吸附试验 流式细胞术 META分析 

分 类 号：R744.52[医药卫生—神经病学与精神病学]