Abstract：
OBJECTIVE: This study aimed to assess the diagnostic potential of the Antibody concentration ratio in identifying treatment-refractory myasthenia gravis (MG).
METHODS: A retrospective analysis was conducted on 116 MG patients who underwent antibody detection at least twice between June 1, 2015, and June 1, 2023. Demographic and clinical characteristics were collated to ascertain their association with refractory MG. The Antibody Concentration Ratio was applied to determine treatment response, using the International Consensus Guidance criteria as the reference standard. The area under nonparametric receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were calculated to assess the diagnostic efficacy of the Antibody concentration ratio following consecutive immunotherapy relative to initial antibody concentrations for refractory MG.
RESULTS: 19 out of 116 patients were unequivocally diagnosed with refractory MG. A significant correlation was found between the Antibody Concentration Ratio and refractory MG status in treatment-refractory and treatment-responsive patients. Subsequently, the AUC demonstrated the robust diagnostic capability of the Antibody concentration ratio for refractory MG, with an AUC of 0.8709 (95% CI: 0.7995-0.9422, p < 0.0001). The optimal cut-off value stood at 0.8903, exhibiting a sensitivity of 94.74% (95% CI: 75.36%-99.73%), a specificity of 68.04% (95% CI: 58.23%-76.48%), and accuracy of 72.41% (95% CI: 64.28%-80.54%).
CONCLUSIONS: Elevated Antibody Concentration Ratio is intrinsically linked with refractory MG and exhibits potential as an diagnostic biomarker for the condition.
METHODS: A retrospective analysis was conducted on 116 MG patients who underwent antibody detection at least twice between June 1, 2015, and June 1, 2023. Demographic and clinical characteristics were collated to ascertain their association with refractory MG. The Antibody Concentration Ratio was applied to determine treatment response, using the International Consensus Guidance criteria as the reference standard. The area under nonparametric receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were calculated to assess the diagnostic efficacy of the Antibody concentration ratio following consecutive immunotherapy relative to initial antibody concentrations for refractory MG.
RESULTS: 19 out of 116 patients were unequivocally diagnosed with refractory MG. A significant correlation was found between the Antibody Concentration Ratio and refractory MG status in treatment-refractory and treatment-responsive patients. Subsequently, the AUC demonstrated the robust diagnostic capability of the Antibody concentration ratio for refractory MG, with an AUC of 0.8709 (95% CI: 0.7995-0.9422, p < 0.0001). The optimal cut-off value stood at 0.8903, exhibiting a sensitivity of 94.74% (95% CI: 75.36%-99.73%), a specificity of 68.04% (95% CI: 58.23%-76.48%), and accuracy of 72.41% (95% CI: 64.28%-80.54%).
CONCLUSIONS: Elevated Antibody Concentration Ratio is intrinsically linked with refractory MG and exhibits potential as an diagnostic biomarker for the condition.
摘要：
目的：本研究旨在评估抗体浓度比在鉴定难治性重症肌无力（MG）方面的诊断潜力。
方法：对2015年6月1日至2023年6月1日期间至少两次接受抗体检测的116例MG患者进行了回顾性分析。对人口统计学和临床特征进行了整理，以确定它们与难治性MG的关系。抗体浓度比用于确定治疗反应，使用国际共识指导标准作为参考标准。非参数接收器工作特性曲线下面积(AUC)，灵敏度,特异性，计算和准确性，以评估连续免疫疗法后抗体浓度比相对于难治性MG初始抗体浓度的诊断功效。
结果：116例患者中有19例明确诊断为难治性MG。在治疗难治性和治疗响应性患者中，抗体浓度比与难治性MG状态之间存在显着相关性。随后，AUC证明了抗体浓度比对难治性MG的强大诊断能力，AUC为0.8709（95%CI：0.7995-0.9422，p<0.0001）。最佳临界值为0.8903，灵敏度为94.74%(95%CI:75.36%-99.73%)，特异性为68.04%（95%CI：58.23%-76.48%），准确率为72.41%(95%CI:64.28%-80.54%)。
结论：升高的抗体浓度比与难治性MG内在相关，并显示出作为该病症的诊断生物标志物的潜力。
方法：对2015年6月1日至2023年6月1日期间至少两次接受抗体检测的116例MG患者进行了回顾性分析。对人口统计学和临床特征进行了整理，以确定它们与难治性MG的关系。抗体浓度比用于确定治疗反应，使用国际共识指导标准作为参考标准。非参数接收器工作特性曲线下面积(AUC)，灵敏度,特异性，计算和准确性，以评估连续免疫疗法后抗体浓度比相对于难治性MG初始抗体浓度的诊断功效。
结果：116例患者中有19例明确诊断为难治性MG。在治疗难治性和治疗响应性患者中，抗体浓度比与难治性MG状态之间存在显着相关性。随后，AUC证明了抗体浓度比对难治性MG的强大诊断能力，AUC为0.8709（95%CI：0.7995-0.9422，p<0.0001）。最佳临界值为0.8903，灵敏度为94.74%(95%CI:75.36%-99.73%)，特异性为68.04%（95%CI：58.23%-76.48%），准确率为72.41%(95%CI:64.28%-80.54%)。
结论：升高的抗体浓度比与难治性MG内在相关，并显示出作为该病症的诊断生物标志物的潜力。
