Histopathological Diagnostic Value of the IgG4(+)/IgG(+) Ratio of Plasmacytic Infiltration for IgG4-Related Diseases: A PRISMA-Compliant Systematic Review and Meta-Analysis

This article aims to perform a meta-analysis to evaluate the diagnostic value of the immunoglobulin G (IgG)4(+)/IgG(+) ratio of plasmacytic infiltration for IgG4-related diseases. Four databases—EMBASE, ISI Web of Knowledge, PubMed, and the Cochrane Library—were systematically searched. Approximately 200 participants from several studies were included in this research. STATA 11.2 software (Stata Corporation, College Station, TX) and Meta-DiSc 1.4 (Unit of Clinical Biostatistics, Ramon y Cajal Hospital, Madrid, Spain) were used to perform the meta-analysis. Nine studies were included in the meta-analysis. The pooled diagnostic odds ratio was 18.94 [95% confidence interval (CI), 2.89–124.30]. The sensitivity was 58.80% (95% CI, 50.90–66.30) and the specificity was 90.20% (95% CI, 81.20–95.80). The positive and negative likelihood ratios were 3.12 (95% CI, 1.07–9.16) and 0.26 (95% CI, 0.09–0.70), respectively. The area under the curve of the summary receiver-operating characteristic was 0.88. To conclude, the IgG4(+)/IgG(+) ratio of plasmacytic infiltration is modestly effective in diagnosing IgG-related disease.