Diagnostic accuracy of mac-2-binding protein glycosylation isomer for diagnosing hepatitis B-related fibrosis: A meta-analysis.

OBJECTIVES: Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel biomarker for liver fibrosis. The aim of this meta-analysis was to evaluate the accuracy of M2BPGi for predicting hepatitis B virus (HBV)-related liver fibrosis. METHODS: EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure, SinoMED, VIP Database for Chinese Technical Periodicals databases were searched comprehensively for articles published up to March 2022. Quality assessment was carried out in accordance with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled diagnostic estimates including sensitivity, specificity, the area under the summary receiver operating characteristic curve (AUROC) were calculated. Before pooling the estimates, the threshold effect was assessed. Subgroup analysis was performed as well. RESULTS: In all, 11 studies including 1836 patients were included. None of the 11 studies met all the criteria of QUADAS-2. The threshold effect was found (r = 0.757, P = 0.011) for predicting HBV-related severe fibrosis. The sensitivity, specificity and AUROC of M2BPGi for the prediction of significant fibrosis were 0.68 (0.65-0.71), 0.67 (0.64-0.70) and 0.741, respectively, while those for predicting cirrhosis were 0.65 (0.57-0.72), 0.79 (0.77-0.81) and 0.792. Additionally, the AUROC of M2BPGi for predicting severe fibrosis reached 0.766. No publication bias was observed. The results of subgroup analyses were similar to the overall results. CONCLUSIONS: M2BPGi has moderate diagnostic accuracy for predicting HBV-related significant fibrosis, severe fibrosis, and cirrhosis. Further studies stratified by etiology, liver inflammation, treatment, etc, are urgently needed.

Diagnostic accuracy of γ-glutamyl transpeptidase-to-platelet ratio for predicting hepatitis B-related fibrosis: a meta-analysis.

BACKGROUND AND AIM: Emerging published data on the accuracy of γ-glutamyl transpeptidase-to-platelet ratio (GPR) for diagnosing hepatitis B virus (HBV)-related fibrosis are inconsistent. The aim of this study was to systematically review the performance of GPR for diagnosing HBV-related significant fibrosis, severe fibrosis, and cirrhosis. PATIENTS AND METHODS: A comprehensive literature search of PubMed, Web of Science, and EMBASE was conducted before July 2018. Study selection was performed according to inclusion and exclusion criteria. The relevant parameters of eligible studies were abstracted. The methodological quality was assessed according to the Quality Assessment of Diagnostic Accuracy Studies. Areas under summary receiver operating characteristic curves, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratios were used to examine the GPR accuracy for the diagnosis of significant fibrosis, severe fibrosis, and cirrhosis. RESULTS: A total of 10 studies including 5882 patients with HBV infection underwent liver biopsy were incorporated. The prevalence of significant fibrosis, severe fibrosis, and cirrhosis were 58% (range: 22-72%), 36% (range: 10-55%), and 19% (range: 2-33%), respectively. Areas under summary receiver operating characteristic curves of GPR for predicting significant fibrosis, severe fibrosis, and cirrhosis were 0.733, 0.777, and 0.796, respectively. Subgroup analysis was performed according to geographical region and histological scoring system with similar results. CONCLUSION: GPR has moderate diagnostic accuracy for predicting HBV-related significant fibrosis, severe fibrosis, and cirrhosis, and further studies with large sample size, rigorous design, multicenter study population are urgently needed.

Serum IgG4 and IgG for the diagnosis of autoimmune pancreatitis: A systematic review with meta-analysis.

BACKGROUND AND OBJECTIVE: The correct diagnosis of autoimmune pancreatitis (AIP) is a clinical challenge. Emerging published data on the accuracy of serum IgG4 and IgG for diagnosing AIP are inconsistent. This study was performed to better elucidate the accuracy of serum IgG4 and IgG in diagnosing AIP. METHODS: A comprehensive literature search of PubMed, Web of Science, EMBASE, the Cochrane Library and some other databases was conducted before October 2014. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Random-effects model was used to summarize the sensitivity, specificity and other measures of accuracy. RESULTS: Fifteen studies on IgG4 and 8 studies on IgG were included. The summary estimates for serum IgG4 in distinguishing AIP from the overall controls, pancreatic cancer and ordinary chronic pancreatitis were as follows: sensitivity 0.74 (0.70-0.77), 0.73 (0.69-0.77) and 0.76 (0.72-0.80), respectively, specificity, 0.94 (0.93-0.95), 0.93 (0.91-0.95) and 0.96 (0.95-0.97), respectively. The summary estimates for serum IgG in distinguishing AIP from the overall controls and pancreatic cancer were as follows: sensitivity, 0.53 (0.47-0.59) and 0.51 (0.44-0.57), respectively, specificity, 0.87 (0.85-0.89) and 0.94 (0.91-0.96), respectively. The area under the curve (AUC) of serum IgG in distinguishing AIP from ordinary chronic pancreatitis was 0.657. CONCLUSIONS: Both serum IgG4 and IgG have high specificity and relatively low sensitivity for diagnosing AIP. Besides, they are useful for distinguishing AIP from pancreatic cancer and ordinary chronic pancreatitis. To better elucidate the usefulness of serum IgG4 and IgG, further studies are needed.