Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center-IRCCS, Milano, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
J Neurol Neurosurg Psychiatry. 2022 Dec;93(12):1239-1246. doi: 10.1136/jnnp-2022-329357. Epub 2022 Sep 8.
To compare the sensitivity and specificity of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS).
Sensitivity and specificity of the two sets of criteria were evaluated in 330 patients with CIDP and 166 axonal peripheral neuropathy controls. Comparison of the utility of nerve conduction studies with different number of nerves examined and of the sensitivity and specificity of the two criteria in typical CIDP and its variants were assessed.
EFNS/PNS criteria had a sensitivity of 92% for possible CIDP and 85% for probable/definite CIDP, while the EAN/PNS criteria had a sensitivity of 83% for possible CIDP and 74% for CIDP. Using supportive criteria, the sensitivity of the EAN/PNS criteria for possible CIDP increased to 85% and that of CIDP to 77%, remaining lower than that of the EFNS/PNS criteria. Specificity of the EFNS/PNS criteria was 68% for possible CIDP and 84% for probable/definite CIDP, while the EAN/PNS criteria had a specificity of 88% for possible CIDP and 98% for CIDP. More extended studies increased the sensitivity of both sets of criteria by 4%-7% but reduced their specificity by 2%-3%. The EFNS/PNS criteria were more sensitive for the diagnosis of typical CIDP while the EAN/PNS criteria were more specific for the diagnosis of distal and sensory CIDP.
In our population, the EAN/PNS criteria were more specific but less sensitive than the EFNS/PNS criteria. With the EAN/PNS criteria, more extended nerve conduction studies are recommended to obtain an acceptable sensitivity while maintaining a high specificity.
比较 2021 年欧洲神经病学会/周围神经学会（EAN/PNS）慢性炎症性脱髓鞘性多发性神经病（CIDP）诊断标准与 2010 年欧洲神经病学会联合会/周围神经学会（EFNS/PNS）标准的敏感性和特异性。
对 330 例 CIDP 患者和 166 例轴索性周围神经病对照患者的两套标准的敏感性和特异性进行评估。比较不同神经检查数量的神经传导研究的效用以及两种标准在典型 CIDP 及其变体中的敏感性和特异性。
EFNS/PNS 标准对可能的 CIDP 的敏感性为 92%，对可能/确定的 CIDP 的敏感性为 85%，而 EAN/PNS 标准对可能的 CIDP 的敏感性为 83%，对 CIDP 的敏感性为 74%。使用支持性标准，EAN/PNS 标准对可能的 CIDP 的敏感性增加到 85%，对 CIDP 的敏感性增加到 77%，仍低于 EFNS/PNS 标准。EFNS/PNS 标准对可能的 CIDP 的特异性为 68%，对可能/确定的 CIDP 的特异性为 84%，而 EAN/PNS 标准对可能的 CIDP 的特异性为 88%，对 CIDP 的特异性为 98%。更广泛的研究使两种标准的敏感性分别增加了 4%-7%，但特异性分别降低了 2%-3%。EFNS/PNS 标准对典型 CIDP 的诊断更敏感，而 EAN/PNS 标准对远端和感觉性 CIDP 的诊断更特异。
在我们的人群中，EAN/PNS 标准比 EFNS/PNS 标准更特异但敏感性较低。使用 EAN/PNS 标准，建议进行更广泛的神经传导研究以获得可接受的敏感性，同时保持高特异性。
