流式荧光免疫法检测原发性胆汁性胆管炎自身抗体的价值与临床应用

王战; 王麟; 姚远; 刘静; 孙桂荣; 刘明军

doi:10.3969/j.issn.1001-5256.2021.10.025

流式荧光免疫法检测原发性胆汁性胆管炎自身抗体的价值与临床应用

DOI: 10.3969/j.issn.1001-5256.2021.10.025

青岛大学附属医院检验科，山东青岛 266003

基金项目:

青岛大学附属医院青年科研基金 (20141201)

详细信息

通信作者:
刘明军，jocklmj@163.com

中图分类号: R575.22
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- 被引次数: 0
出版历程
- 收稿日期: 2021-02-23
- 录用日期: 2021-03-29
- 出版日期: 2021-10-20

Value and clinical application of multiplex bead-based flow fluorescent immunoassay in the detection of autoantibodies in primary biliary cholangitis

Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China

Research funding:

Scientific Research Fund of The Affiliated Hospital of Qingdao University (20141201)

摘要

摘要: 目的对多重微球流式荧光免疫法(MBFFI)检测抗线粒体抗体(AMA)M2亚型、抗核孔膜蛋白抗体(gp210抗体)与抗核体蛋白抗体(sp100抗体)结果进行分析，并评估其对原发性胆汁性胆管炎(PBC)的诊断价值。方法选取2018年8月—2020年6月于青岛大学附属医院就诊并临床确诊的PBC患者340例(PBC组)，其他疾病组143例，健康体检者117例。应用MBFFI与免疫印迹法(IBT)分别检测受试者血清中AMA-M2、gp210、sp100 3种自身抗体，用Kappa检验比较两种方法对同一种自身抗体检测结果的一致性；应用受试者工作特征曲线评估MBFFI检测3种抗体对PBC的诊断价值；阳性率的比较采用χ²检验。结果 PBC组中两种方法检测一致性最好的抗体为AMA-M2(Kappa=0.874)，gp210与sp100抗体的一致性较好(Kappa=0.713，Kappa=0.749)。MBFFI检测AMA-M2抗体的敏感度(72.06%)最高；联合检测gp210与sp100两种抗体的敏感度(44.71%)高于单项抗体，联合检测AMA-M2、gp210与sp100 3种抗体的敏感度(82.65%)高于单项抗体。3种抗体联合检测诊断PBC的受试者工作特征曲线下面积最大(0.907 0)。结论 MBFFI检测PBC自身抗体与IBT检测结果一致性较好。MBFFI联合检测AMA-M2、gp210和sp100抗体诊断PBC的敏感度更高，诊断价值更大。
- 肝硬化, 胆汁性 /
- 荧光免疫测定 /
- 免疫印迹法 /
- 自身抗体 /
- 诊断
Abstract: Objective To investigate the value of multiplex bead-based flow fluorescent immunoassay (MBFFI) in the diagnosis of primary biliary cholangitis (PBC) by analyzing its results in detecting antimitochondrial antibody M2 subtype (AMA-M2), gp210 antibody, and sp100 antibody. Methods A total of 340 patients who attended The Affiliated Hospital of Qingdao University from August 2018 to June 2020 and were diagnosed with PBC were enrolled as PBC group, and 143 patients with other diseases and 117 individuals undergoing physical examination were also enrolled. MBFFI and immunoblotting test (IBT) were used to detect AMA-M2, gp210, and sp100 autoantibodies in serum, and the Kappa-test was used to compare the consistency of the two methods in detecting the same autoantibody; the receiver operating characteristic (ROC) curve was used to evaluate the value of MBFFI detection of three antibodies in the diagnosis of PBC; the chi-square test was used to compare positive. Results In the PBC group, the two methods showed the best consistency in detecting AMA-M2(Kappa=0.874) and showed relatively good consistency in detecting gp210 and sp100 antibodies (Kappa=0.713 and 0.749). MBFFI had the highest sensitivity of 72.06% in detecting AMA-M2; it had a sensitivity of 44.71% in the combined detection of gp210 and sp100 antibodies, which was higher than its sensitivity in detecting each antibody alone; it had a sensitivity of 82.65% in the combined detection of AMA-M2, gp210, and sp100 antibodies, which was higher than its sensitivity in detecting each antibody alone. Combined detection of the three antibodies had the largest area under the ROC curve of 0.907 0 in the diagnosis of PBC. Conclusion MBFFI has good consistency with IBT in detecting autoantibodies associated with PBC, and the combined detection of AMA-M2, gp210, and sp100 antibodies by MBFFI has higher sensitivity and value in the diagnosis of PBC.
- Liver Cirrhosis, Biliary /
- Fluoroimmunoassay /
- Immunoblotting /
- Autoantibodies /
- Diagnosis

HTML全文

图 1 MBFFI检测AMA-M2、gp210、sp100 3种抗体的ROC曲线

下载: 全尺寸图片幻灯片

表 1 MBFFI与IBT检测所有样本总体一致性比较

抗体	阳性率[例(%)]		一致率(%)	Kappa指数
抗体	MBFFI	IBT	一致率(%)	Kappa指数
AMA-M2	262(43.67)	255(42.50)	94.83	0.895
gp210	103(17.17)	110(18.33)	91.50	0.709
sp100	87(14.50)	62(10.33)	93.83	0.718

下载: 导出CSV

表 2 MBFFI与IBT对PBC组患者血清自身抗体检测结果比较

抗体	阳性率[例(%)]		一致率(%)	Kappa指数
抗体	MBFFI	IBT	一致率(%)	Kappa指数
AMA-M2	245(72.06)	250(73.53)	95.00	0.874
gp210	96(28.24)	100(29.41)	88.24	0.713
sp100	76(22.35)	57(16.76)	92.05	0.749

下载: 导出CSV

表 3 MBFFI检测AMA-M2、gp210与sp100抗体的诊断性能

项目	敏感度	特异度	阳性预测值	阴性预测值	假阳性率(误诊率)	假阴性率(漏诊率)	约登指数	阳性似然比	阴性似然比	ROC曲线下面积	95% CI
AMA-M2	72.06%	93.54%	93.51%	72.14%	6.46%	27.94%	0.66	11.15	0.30	0.850 3	0.819 4~0.881 3
gp210	28.24%	97.34%	93.20%	51.20%	2.66%	71.76%	0.26	10.61	0.74	0.703 9	0.660 3~0.744 8
sp100	22.35%	95.82%	87.36%	48.84%	4.18%	77.65%	0.18	5.34	0.81	0.635 2	0.591 3~0.679 1
gp210+sp100	44.71%	93.49%	89.94%	56.48%	6.51%	55.29%	0.38	6.86	0.59	0.742 0	0.703 3~0.780 7
AMA-M2+gp210+sp100	82.65%	88.12%	90.06%	79.58%	11.88%	17.35%	0.71	6.96	0.20	0.907 0	0.884 0~0.929 9

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