Li Ping, Chen Hua, Deng Chuiwen, Wu Ziyan, Lin Wei, Zeng Xiaofeng, Zhang Wen, Zhang Fengchun, Li Yongzhe
a Department of Rheumatology and Clinical Immunology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China.
Mod Rheumatol. 2016 Jul;26(4):583-7. doi: 10.3109/14397595.2015.1117171. Epub 2015 Dec 23.
This study was performed to better know diagnosis associated with serum IgG4 concentration, and to explore the possibility for development of a serum IgG4 for IgG4-related disease (IgG4-RD) in Chinese populations.
We studied retrospectively 497 IgG4 serum subclass measurements from Peking Union Medical College Hospital during the four-year period, including 242 IgG4-RD, 130 other diseases and 125 healthy individuals.
Serum IgG4 concentrations were significantly higher in IgG4-RD than in other pathologies (1662.9 ± 3760.9 mg/L, p < 0.001) and healthy individuals (538.2 ± 458.6 mg/L, p < 0.001). There were no significant differences in serum IgG4 level between other pathologies group and healthy individuals (p = 0.075). Among the 242 IgG4-RD patients analyzed, serum IgG4 concentrations were normal in 46 patients (19.0%). We found 32 patients (24.6%) with elevated serum IgG4 levels among the 130 patients who suffered from other pathologies. There were seven (5.6%) with serum IgG4 over 1350 mg/L in healthy individuals. The ROC curve analysis revealed that the optimal sensitivity and specificity were 80.0% and 88.2%, respectively, at the concentration of 1575 mg/L for Chinese patients.
Our study demonstrated that serum IgG4 elevation was not specific of IgG4-RD. Further studies are needed to define the sensibility and specificity of IgG4 values for the diagnosis of IgG4-RD.
本研究旨在更深入了解与血清IgG4浓度相关的诊断，并探索在中国人群中开发用于IgG4相关疾病（IgG4-RD）的血清IgG4检测方法的可能性。
我们回顾性研究了北京协和医院在四年期间的497例IgG4血清亚类检测结果，其中包括242例IgG4-RD患者、130例其他疾病患者和125名健康个体。
IgG4-RD患者的血清IgG4浓度显著高于其他疾病患者（1662.9±3760.9mg/L，p<0.001）和健康个体（538.2±458.6mg/L，p<0.001）。其他疾病组与健康个体之间的血清IgG4水平无显著差异（p=0.075）。在分析的242例IgG4-RD患者中，46例（19.0%）血清IgG4浓度正常。在130例患有其他疾病的患者中，我们发现32例（24.6%）血清IgG4水平升高。健康个体中有7例（5.6%）血清IgG4超过1350mg/L。ROC曲线分析显示，对于中国患者，浓度为1575mg/L时，最佳敏感性和特异性分别为80.0%和88.2%。
我们的研究表明，血清IgG4升高并非IgG4-RD所特有。需要进一步研究来确定IgG4值对IgG4-RD诊断的敏感性和特异性。
