Hu Shiling, Zhao Fengrong, Wang Qingsong, Chen Wei-Xian
Clin Chem Lab Med. 2014 Nov;52(11):1533-42. doi: 10.1515/cclm-2013-0926.
The aim of this study was to evaluate the diagnostic value of anti-mitochondrial antibodies (AMAs) and/or the M2 subtype (AMA-M2) in patients with primary biliary cirrhosis (PBC). AMA/AMA-M2 data were obtained by searching electronic databases. Studies showing AMA/AMA-M2 results in patients with PBC and control groups with other liver diseases or healthy livers were included. The quality of the involved studies was assessed using the QUADAS tool. The pooled sensitivity and specificity were calculated, and stratified analysis was performed according to possible heterogeneity sources. The pooled AMA (all methods) sensitivity and specificity were 84.5% (95% confidence interval (CI) 83.3%-85.6%) and 97.8% (95% CI 97.6%-98.0%), respectively. The positive and negative likelihood ratios were 25.201 (95% CI 17.583-36.118) and 0.162 (95% CI 0.131-0.199), respectively. The current evidence suggests that AMA and AMA-M2 show favorable accuracy for the diagnosis of PBC with high specificity and sensitivity. AMA is a better and more comprehensive marker than AMA-M2. The accuracy established in this meta-analysis is based on clinical studies using patient cohorts from different ethnicities.
本研究旨在评估抗线粒体抗体（AMA）和/或M2亚型（AMA-M2）在原发性胆汁性肝硬化（PBC）患者中的诊断价值。通过检索电子数据库获取AMA/AMA-M2数据。纳入显示PBC患者以及患有其他肝脏疾病的对照组或健康肝脏对照组的AMA/AMA-M2结果的研究。使用QUADAS工具评估所纳入研究的质量。计算合并敏感度和特异度，并根据可能的异质性来源进行分层分析。AMA（所有方法）合并敏感度和特异度分别为84.5%（95%置信区间（CI）83.3%-85.6%）和97.8%（95%CI 97.6%-98.0%）。阳性和阴性似然比分别为25.201（95%CI 17.583-36.118）和0.162（95%CI 0.131-0.199）。目前的证据表明，AMA和AMA-M2在诊断PBC方面具有良好的准确性，具有高特异性和敏感性。AMA是比AMA-M2更好、更全面的标志物。本荟萃分析中确立的准确性基于使用来自不同种族患者队列的临床研究。
