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| Application value of serum anti-M-type phospholipase A2 receptor antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy |
| CHEN Zhao-sheng |
| Department of Clinical Laboratory,Qingdao Third People′s Hospital,Shandong Province,Qingdao 266000,China |
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Abstract Objective To investigate the application value of serum anti-M-type phospholipase A2 receptor (PLA2R)antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy. Methods From March 2016 to April 2019,86 patients with membranous nephropathy in our hospital were selected,and 52 cases of idiopathic membranous nephropathy found by renal biopsy were included in the idiopathic group,34 cases of secondary membranous nephropathy were included in the secondary group.The venous blood and mid-range urine samples were collected from two groups of patients for detecting serum PLA2R antibody and urine IgG4 indicators.The positive rate of serum anti PLA2R antibody was compared between the two groups,and the specificity,sensitivity and accuracy were analyzed.At the same time,the results of urine IgG4 of the two groups were compared and ROC curve was analyzed. Results The positive rate of serum anti-PLA2R antibody detection in the idiopathic group (90.38%) was higher than that in the secondary group (5.88%),the difference was statistically significant (P＜0.05).The specificity,sensitivity and accuracy of serum anti PLA2R antibody in the diagnosis of idiopathic membranous nephropathy were 94.12% (32/34),90.38% (47/52) and 91.86% (79/86),respectively.The urinary IgG4 in the idiopathic group was (0.79±0.12) g/L,which was higher than that in the secondary group ([0.52±0.08]g/L),the difference was statistically significant (P＜0.05).The ROC curve showed that the area under the curve of urine IgG4 in the diagnosis of idiopathic membranous nephropathy was 0.856 (detection result ＞0.7),the specificity and sensitivity were 82.70% and 50.00%,respectively.The diagnostic value was relatively ideal.The specificity and sensitivity of serum anti PLA2R antibody in the diagnosis of idiopathic membranous nephropathy were higher than those of urine IgG4,the differences were statistically significant (P＜0.05).Conclusion The positive rate of serum anti PLA2R antibody and urine IgG4 in patients with idiopathic membranous nephropathy are significantly higher than those in patients with secondary membranous nephropathy,which can be used as a reference for clinical diagnosis of idiopathic membranous nephropathy.
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