Diagnostic value of anti-MDA5 antibody for interstitial lung disease in adult or juvenile dermatomyositis: A meta-analysis
10.13602/j.cnki.jcls.2018.01.14
- VernacularTitle:抗MDA5抗体对成年及幼年型皮肌炎合并间质性肺病诊断效能的meta分析
- Author:
Yi WANG
1
;
Ying LI
;
Shengjin LI
Author Information
1. 重庆医科大学附属第二医院呼吸科
- Keywords:
anti-melanoma differentiation-associated gene 5 antibody;
dermatomyositis;
interstitial lung disease;
meta-analysis
- From:
Chinese Journal of Clinical Laboratory Science
2018;36(1):46-52
- CountryChina
- Language:Chinese
-
Abstract:
Objective The current meta-analysis was performed to update the evidcnce on anti-melanoma differentiation-associated gene 5 (MDA5) antibody for the diagnosis of rapid progressive interstitial lung disease (RPILD) and chronic ILD in adult or juvenile dermatomyositis (JDM).Methods The electronic search on PubMed,Embase,Cochrane Library,CNKI,WangFang Data,VIP and China Biology Medicine database was conducted from their inception to May,2017.Meta-disc1.4 was used to calculate heterogeneity and obtain the pool sensitivity,specificity,diagnostic odds ratio,positive and negative likelihood ratios and summarized receiver operating characteristic (SROC) curve.Quality assessment and publication bias were determined by QUADAS-2 and STATA 12.0.Results A total of 32 studies with high quality and middle heterogeneity were selected for the final data synthesis.Anti-MDA5 showed a higher diagnostic and prognostic value for RPILD (AUC =0.927,Q * =0.862),compared with chronic ILD (AUC =0.717,Q * =0.667) in adult dermatomyositis patients.For diagnosing RPILD in JDM,the value of MDA5 detection (AUC =0.836,Q * =0.768)was weak.For the prediction of RPILD,the validity of anti-MDA5 detection in clinical amyopathic dermatomyositis (CADM) (AUC =0.942,Q* =0.880) was higher than that in DM (AUC =0.926,Q * =0.860),which was also more applicable to East-Asia populations (AUC =0.960,Q* =0.891),compared with Chinese (AUC =0.925,Q* =0.859) and Western populations (AUC =0.928,Q* =0.863).The methodological assessment for different anti-MDA5 detection implied ELISA (AUC =0.929,Q* =0.864) was superior in performance as immunoprecipitation (AUC =0.927,Q* =0.859),and there was no publication bias according to Deek's plot.Conclusion Anti-MDA5 antibody should be a significant laboratory index for diagnosis and prediction of ILD in adult DM and JDM with high sensitivity and specificity.
