Value of serum IgG4 in distinguishing autoimmune pancreatitis from pancreatic cancer: a Meta-analysis

Objective To investigate the usefulness of serum IgG4 in distinguishing autoimmune pancreatitis(AIP)from pancreatic cancer. Methods The related studies about the usefulness of serum IgG4 in distinguishing autoimmune pancreatitis from pancreatic cancer which were published in Medline, EMBASE, Springer link, Wanfang, Weipu and CNKI before June 1, 2017 were searched.Studies were selected according to strict determined inclusion and exclusion criteria.Publication bias was analyzed by Stata 12.0 software.The quality of the literature was evaluated by the quality evaluation tool(QUADAS). Meta-Disc 1.4 statistical software was used for heterogeneity analysis and comprehensive quantitative synthesis, and the pooled sensitivity, specificity, positive likelihood and diagnostic odds ratio were calculated respectively, and summary receiver operating characteristic(SROC)curve was drawn.The subgroup analysis was performed according to the regional, diagnostic criteria and serum IgG4 detection method respectively. Results A total of 16 studies were included, the pooled sensitivity was 0.727(95%CI: 0.691 to 0.761), the pooled specificity was 0.924(95%CI: 0.907 to 0.939), the pooled positive likelihood ratio was 10.103(95%CI: 6.795 to 15.022), the pooled diagnostic odds ratio was 50.644(95%CI: 26.473 to 96.883). Subgroup analysis showed that the region was the leading source of heterogeneity.Deeks revealed no publication bias, and sensitivity analysis revealed that the results of this meta-analysis were stable. Conclusion Serum IgG4 has high efficiency in the identification of AIP and pancreatic cancer, while due to geographical differences, the regional diagnostic efficacy is inconsistent.More high-quality forward-looking articles for diagnosis of AIP are needed to provide basis. Key words: Serum IgG4; Autoimmune pancreatitis; Pancreatic cancer; Meta-analysis