Table 5.
Combined diagnostic performance of specific anti-phospholipid antibody tests with and without LAC for anti-phospholipid syndrome (APS)
| Test combinations | Isotype(s) | AUC (95% CI) | Sensitivity (95% CI) | Specificity (95% CI) | Odds ratio (95% CI) | |
|---|---|---|---|---|---|---|
| With LAC | aCL and aβ2GPI | IgG | 0·979 (0·988–0·999)** | 100 (71·5–100) | 95·7 (89·4–98·8) | 475·4 (23·1–9056·5) |
| IgM | 0·877 (0·755–0·999)** | 81·8 (48·2–97·7) | 93·6 (86·5–97·6) | 65·3 (11·4–372·2) | ||
| IgG/IgM | 0·957 (0·928–0·986)** | 100 (71·5–100) | 91·4 (83·8–96·2) | 231·4 (12·5–4280·4) | ||
| aPS/PT and aβ2GPI | IgG | 0·962 (0·935–0·989)** | 100 (71·5–100) | 92·5 (85·1–96·9) | 265·3 (14·2–4958·2) | |
| IgM | 0·906 (0·812–1·00)** | 90·9 (58·7–99·8) | 90·3 (82·4–95·5) | 93·3 (10·7–815·4) | ||
| IgG/IgM | 0·930 (0·895–0·966)** | 100 (71·5–100) | 86·0 (77·3–92·3) | 137·2 (7·6–2466·5) | ||
| aCL and aPS/PT | IgG | 0·962 (0·935–0·989)** | 100 (71·5–100) | 92·5 (85·1–96·9) | 265·3 (14·2–4958·2) | |
| IgM | 0·906 (0·812–1·00)** | 90·9 (58·7–99·8) | 90·3 (82·4–95·5) | 93·3 (10·7–815·4) | ||
| IgG/IgM | 0·925 (0·888–0·961)** | 100 (71·5–100) | 85·0 (76·0–91·5) | 126·1 (7·0–2260·4) | ||
| aCL, aPS/PT and aβ2GPI | IgG | 0·962 (0·935–0·989)** | 100 (71·5–100) | 92·5 (85·1–96·9) | 265·3 (14·2–4958·2) | |
| IgM | 0·906 (0·812–0·100)** | 90·9 (58·7–99·8) | 90·3 (82·4–95·5) | 93·3 (10·68–815·4) | ||
| IgG/IgM | 0·925 (0·888–0·961)** | 100 (71·5–100) | 85·0 (76·0–91·5) | 126·1 (7·0–2260·4) | ||
| Without LAC | aCL and aβ2GPI | IgG | 0·620 (0·481–0·759)* | 27·3 (6·0–61·0) | 96·8 (90·9–99·3) | 11·3 (1·9–65·1) |
| IgM | 0·521 (0·501–0·542) | 0·0 (0·0–32·1) | 95·7 (89·4–98·8) | 0·9 (0·04–17·1) | ||
| IgG/IgM | 0·599 (0·458–0·739)* | 27·3 (6·0–61·0) | 92·5 (85·1–96·9) | 4·6 (0·99–21·4) | ||
| aPS/PT and aβ2GPI | IgG | 0·786 (0·635–0·904)** | 63·6 (30·8–89·1) | 93·6 (86·5–97·6) | 25·4 (5·8–111·6) | |
| IgM | 0·690 (0·533–0·846)* | 45·5 (16·8–76·6) | 92·5 (85·1–96·9) | 10·2 (2·5–42·1) | ||
| IgG/IgM | 0·754 (0·601–0·907)** | 63·6 (30·8–89·1) | 81·7 (78·6–93·2) | 11·8 (3·0–46·5) | ||
| aCL and aPS/PT | IgG | 0·786 (0·635–0·937)** | 63·6 (30·8–89·1) | 93·6 (86·5–97·6) | 25·4 (5·8–111·6) | |
| IgM | 0·690 (0·533–0·846)* | 45·5 (16·8–76·6) | 92·5 (85·1–96·9) | 10·2 (2·5–42·1) | ||
| IgG/IgM | 0·748 (0·595–0·902)** | 63·6 (30·8–89·1) | 86·0 (77·3–92·3) | 10·8 (2·8–42·0) | ||
| aCL, aPS/PT and aβ2GPI | IgG | 0·786 (0·635–0·937)** | 63·6 (30·8–89·1) | 93·6 (86·5–97·6) | 25·4 (5·8–111·6) | |
| IgM | 0·690 (0·533–0·805)* | 45·5 (16·8–76·6) | 92·5 (85·1–96·9) | 10·2 (2·5–42·1) | ||
| IgG/IgM | 0·748 (0·595–0·902)** | 63·6 (30·8–89·1) | 86·0 (77·3–92·3) | 10·8 (2·8–42·0) | ||
*
P ≤ 0·002
**
P = 0·0001. AUC = area under the curve; CI = confidence interval; LAC = lupus anti-coagulant; Ig = immunoglobulin; aCL = anti-cardiolipin; aPS/PT = anti-phosphatidylserine/prothrombin complex; GPI = glycoprotein I.