Meta‐Analysis of the Diagnostic Efficiency of THSD7A‐AB for the Diagnosis of Idiopathic Membranous Nephropathy

Thrombospondin type I domain‐containing 7A (THSD7A), is a specific autoantigen of adult idiopathic membranous nephropathy (IMN), whose circulating antibody (THSD7A‐AB) represents a promising biomarker for diagnosis of IMN. The objective of this meta‐analysis is to investigate the diagnostic efficiency of THSD7A‐AB for IMN. After rigorous data extraction, quality assessment, and data analysis, 10 articles (4545 patients) are included. For IMN, the summary sensitivity is 4% (2–7%), and the specificity is 99% (98–100%). The summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR) are 5.40 (2.40–11.90) and 0.97 (0.95–0.99), respectively. The diagnostic odds ratio (DOR) is 6.00 (2.00–12.00). The area under the summary receiver operating characteristic curve (AUC) is 0.78 (0.74–0.81). For M‐type phospholipase A2 receptor (PLA2R)‐negative IMN, the summary sensitivity is 8% (6–10%), specificity is 100% (99–100%). The summary PLR and NLR are 15.80 (5.70–44.00) and 0.93 (0.91–0.95), respectively. The DOR is 17.00 (6.00–48.00). The AUC is 0.99 (0.98–1.00). THSD7A‐AB has higher diagnostic value in PLA2R‐negative patients than in IMN patients. These results suggest that THSD7A‐AB could possibly be applied as an auxiliary non‐invasive diagnostic method for PLA2R‐negative IMN. The present meta‐analysis systematically assesses the diagnostic efficiency of THSD7A‐AB testing in patients with adult idiopathic membranous nephropathy (IMN) for the first time. It is found that thrombospondin type I domain‐containing 7A (THSD7A)‐AB has a higher diagnostic value for M‐type phospholipase A2 receptor (PLA2R)‐negative patients than for IMN patients. THSD7A‐AB testing can be applied as an auxiliary non‐invasive diagnostic method for PLA2R‐negative IMN.