Association of serum immunoglobulin levels with solid cancer: a systematic review and meta-analysis
A partir d'une revue systématique de la littérature publiée jusqu'en juillet 2018 (15 études incluant au total 1 779 cas de tumeur solide et 1 066 témoins), cette méta-analyse évalue l'association entre les niveaux sériques de différentes classes d'immunoglobulines (IgA, IgG, IgM) et la présence d'une tumeur solide
Background: The nature of humoral immunity in carcinogenesis remains poorly understood. In this systematic review and meta-analysis, we aimed to evaluate the association of serum immunoglobulin classes with solid cancer and test our hypothesis that the immune escape of tumours is accompanied by dysregulated systemic immunoglobulin class-switching.
Methods: Following the PRISMA guidelines, we searched the Cochrane Library, Embase and MEDLINE/Pubmed databases for observational studies investigating the association between serum immunoglobulins (IgA,IgG,IgM) and histologically-confirmed solid cancer in adults.We selected case-control studies explicitly stating that no anti-cancer treatment was administered prior to immunoglobulin measurement. No eligible cohort studies were identified. The primary summary measure was the standardised mean difference(SMD) calculated using a random effects model.
Results: Pooling 11 eligible studies comparing serum IgA levels in 1351 cases and 560 controls revealed a statistically significant SMD (1.50;95%CI 0.96 to 2.04).Non-significant SMDs were observed in 14 studies investigating serum IgG (SMD,-0.02;95%CI-0.22 to 0.18)) and 10 studies reporting serum IgM (SMD, 0.11;95%CI-0.10 to 0.32).Substantial heterogeneity between studies persisted despite multivariate sensitivity analysis.
Conclusion: Serum immunoglobulin levels in solid cancer patients might be skewed towards class-switching to IgA, possibly reflecting Th2-polarised immunity. Impact:Further combinatorial analyses of serum immunoglobulin isotypes alongside other immune parameters in databases and observational studies are warranted.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2019