化学发光免疫分析法与酶联免疫吸附法检测原发性膜性肾病磷脂酶 A2 受体抗体的比较

IF 1.7 Q3 MEDICAL LABORATORY TECHNOLOGY
Xiaotao Ma , Ruiting Wang , Linting Wei , Pengfei Liu , Lanmei Jing , Jinghua Wang , Wei Dong , Xuefei Tian , Rongguo Fu
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引用次数: 0

摘要

目的准确检测磷脂酶 A2 受体(PLA2R)自身抗体对于诊断和监测原发性膜性肾病(pMN)至关重要。虽然酶联免疫吸附试验(ELISA)是常用的检测方法,但其复杂性和耗时性带来了挑战,尤其是对小样本量的检测。化学发光免疫测定(CLIA)已成为临床免疫测定的快速替代方法。本研究旨在比较 CLIA 和 ELISA 检测 PLA2R 自身抗体的灵敏度、特异性和精确度。采用 CLIA 和 ELISA 方法检测所有样本中是否存在 PLA2R 自身抗体。使用 SPSS 26.0 对敏感性、特异性、准确性、阳性预测值(PPV)和阴性预测值(NPV)进行了统计分析。结果 pMN 组血清中抗 PLA2R 抗体水平显著高于 nMN 组(P < 0.05)。CLIA 检测抗 PLA2R 抗体的准确率为 76.96%,而 ELISA 的准确率为 74.78%。CLIA 的灵敏度为 64.83%,而 ELISA 为 60%。不过,两种方法之间的差异没有统计学意义(P > 0.05)。抗 PLA2R 检测的总体定性一致率为 93.35%(95% 置信区间[CI] 89.47-96.3)。ROC曲线分析显示,ELISA和CLIA检测抗PLA2R抗体的AUC分别为0.8737(95%置信区间[CI]0.8270-0.9204)和0.8914(95%置信区间[CI]0.8495-0.9332)。斯皮尔曼相关分析表明,它们之间存在显著相关性(P < 0.05)。结论 CLIA 和 ELISA 在检测原发性膜性肾病的抗 PLA2R 抗体方面表现出相似的准确性和一致性。然而,与 ELISA 相比,CLIA 在自动化和节省时间方面具有明显优势,尤其是在样本量较小的情况下。这一发现表明,CLIA 有可能成为未来首选并被广泛采用的检测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A comparison of chemiluminescent immunoassay and enzyme-linked immunosorbent assay for detecting phospholipase A2 receptor antibody in primary membranous nephropathy

A comparison of chemiluminescent immunoassay and enzyme-linked immunosorbent assay for detecting phospholipase A2 receptor antibody in primary membranous nephropathy

Objective

The accurate detection of phospholipase A2 receptor (PLA2R) autoantibody is crucial in the diagnosis and monitoring of primary membranous nephropathy (pMN). While enzyme-linked immunosorbent assay (ELISA) is the commonly used detection method, its complexity and time-consuming nature pose challenges, especially for small sample sizes. Chemiluminescence immunoassay (CLIA) has emerged as a rapid alternative for clinical immunoassays. This study aims to compare the sensitivity, specificity, and precision of CLIA and ELISA in detecting PLA2R autoantibody.

Method

A total of 145 patients with biopsy-confirmed primary membranous nephropathy and 85 patients with non-membranous nephropathy were enrolled in this comparative study. CLIA and ELISA were employed to test all samples for the presence of PLA2R autoantibodies. Statistical analysis of sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) was performed using SPSS 26.0. The diagnostic value of ELISA and CLIA for pMN was analyzed using the ROC curve, and Correlation analysis was performed using Spearman.

Results

Serum levels of anti-PLA2R antibody in pMN group were significantly higher than those in nMN group(P < 0.05). The accuracy of CLIA for detecting anti-PLA2R antibody was 76.96%, while ELISA showed an accuracy of 74.78%. The sensitivity for CLIA was 64.83%, compared to 60% for ELISA. However, no statistically significant difference was observed between the two methods (P > 0.05). The overall qualitative agreement of anti-PLA2R detection was 93.35% (95% confidence interval[CI] 89.47–96.3). ROC curve analysis showed that AUC of anti-PLA2R antibody detected by ELISA and CLIA were 0.8737 (95% confidence interval [CI] 0.8270–0.9204), 0.8914 (95% confidence interval [CI]0.8495–0.9332), respectively. The Spearman correlation analysis revealed a significant correlation between them(P < 0.05). Notably, CLIA demonstrated a significant time-saving advantage, particularly when the sample size was less than 200, and especially when it was less than 20.

Conclusion

CLIA and ELISA showed similar accuracy and consistency in detecting anti-PLA2R antibody for primary membranous nephropathy. However, CLIA exhibited a significant advantage in terms of automation and time-saving compared to ELISA, particularly for smaller sample sizes. This finding suggests that CLIA has the potential to become a preferred and widely adopted test in the future.

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来源期刊
Practical Laboratory Medicine
Practical Laboratory Medicine Health Professions-Radiological and Ultrasound Technology
CiteScore
3.50
自引率
0.00%
发文量
40
审稿时长
7 weeks
期刊介绍: Practical Laboratory Medicine is a high-quality, peer-reviewed, international open-access journal publishing original research, new methods and critical evaluations, case reports and short papers in the fields of clinical chemistry and laboratory medicine. The objective of the journal is to provide practical information of immediate relevance to workers in clinical laboratories. The primary scope of the journal covers clinical chemistry, hematology, molecular biology and genetics relevant to laboratory medicine, microbiology, immunology, therapeutic drug monitoring and toxicology, laboratory management and informatics. We welcome papers which describe critical evaluations of biomarkers and their role in the diagnosis and treatment of clinically significant disease, validation of commercial and in-house IVD methods, method comparisons, interference reports, the development of new reagents and reference materials, reference range studies and regulatory compliance reports. Manuscripts describing the development of new methods applicable to laboratory medicine (including point-of-care testing) are particularly encouraged, even if preliminary or small scale.
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