Abstract
Objective The diagnostic value of antinuclear antibodies (ANAs) including anti-gp210 and anti-sp100 for primary biliary cholangitis/cirrhosis (PBC) has been widely reported. However, their diagnostic performances for antimitochondrial antibody- (AMA-) negative PBC were less well elucidated. Therefore, the aim of the current meta-analysis was to evaluate the diagnostic accuracy of ANAs in patients with AMA-negative PBC. Materials and Methods Literature on the diagnostic value of biomarkers for AMA-negative PBC was systematically searched in PubMed, MEDLINE, EMBASE, and the Cochrane Library. The qualities of the retrieved studies were assessed by the Quality Assessment of Diagnostic Accuracy Studies-version 2 (QUADAS-2) scale. Pooled sensitivity and specificity of the biomarkers were calculated with random-effects models. The areas under the summary receiver operating characteristic (AUSROC) curves were used to evaluate the overall diagnostic performance of ANAs. Results A total of 11 studies (400 AMA-negative PBC patients and 6217 controls) were finally included in the meta-analysis. ANAs had an overall sensitivity of 27% (95% CI: 20%, 35%) and specificity of 98% (95% CI: 97%, 99%). The pooled sensitivities for anti-gp210 and anti-sp100 were 23% (95% CI: 13%, 37%) and 25% (95% CI: 13%, 43%), respectively, and their specificities were 99% (95% CI: 97%, 100%) and 97% (95% CI: 93%, 98%), respectively. Conclusions ANAs exhibited high specificity but low sensitivity and therefore could be used as reliable biomarkers to reduce the necessity of liver histology.
Highlights
antinuclear antibodies (ANAs) exhibited high specificity but low sensitivity and could be used as reliable biomarkers to reduce the necessity of liver histology
Primary biliary cholangitis (PBC) is a chronic intrahepatic cholestatic disease which is histologically characterized by progressive nonsuppurative cholangitis [1, 2]
11 studies were included in quantitative synthesis and meta-analysis with the following inclusion criteria: (i) assessed the diagnostic accuracy of the ANA test on Antimitochondrial antibody (AMA)-negative primary biliary cholangitis/cirrhosis (PBC) patients and controls; (ii) full-text articles; (iii) showed sufficient information of true positive (TP), false positive (FP), false negative (FN), and true negative (TN) numbers to calculate sensitivity and specificity; and (iv) the publication language should be in either English or Chinese
Summary
The diagnostic value of antinuclear antibodies (ANAs) including anti-gp210 and anti-sp100 for primary biliary cholangitis/cirrhosis (PBC) has been widely reported. Their diagnostic performances for antimitochondrial antibody(AMA-) negative PBC were less well elucidated. The aim of the current meta-analysis was to evaluate the diagnostic accuracy of ANAs in patients with AMA-negative PBC. Literature on the diagnostic value of biomarkers for AMA-negative PBC was systematically searched in PubMed, MEDLINE, EMBASE, and the Cochrane Library. A total of 11 studies (400 AMA-negative PBC patients and 6217 controls) were included in the meta-analysis. The pooled sensitivities for anti-gp210 and anti-sp100 were 23% (95% CI: 13%, 37%) and 25% (95% CI: 13%, 43%), respectively, and their specificities were 99% (95% CI: 97%, 100%) and 97% (95% CI: 93%, 98%), respectively. ANAs exhibited high specificity but low sensitivity and could be used as reliable biomarkers to reduce the necessity of liver histology
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