Abstract: Objective To assess the correlation between serum anti-phospholipase A2 receptor (PLA2R) antibody and clinicopathology and the effect of serum anti-phospholipase A2 receptor antibody on the patients with idiopathic membranous nephropathy(IMN).Methods According to the titers of anti-PLA2R antibody,106 patients were divided into the anti-PLA2R antibody positive group (72 patients) and negative group (34 patients).The clinicopathological characteristics of the two groups were analyzed.Depending on the patient's condition,prednisone combined with cyclophosphamide or tacrolimus was administered.The difference of therapeutic effect between the two groups was compared,and the correlation between titer of anti-PLA2R antibody and therapeutic effect was analyzed.Results The anti-PLA2R antibody positive group had lower serum albumin (t=10.353,P=0.012),higher total cholesterol (t=7.865,P=0.021),higher urinary protein quantification(t=7.156,P=0.028),thicker basement membrane(GBM) (t=6.593,P=0.032),and lower remission rate (χ²=7.370,P=0.007) than the negative group.There was no significant difference in the efficacy between prednisone combined with cyclophosphamide or tacrolimus (χ²=0.168,P=0.682) for IMN.The titer of anti-pla2r antibody before treatment was highly correlated with clinical remission rate in IMN patients (r=0.812,P=0.012).Conclusions Serum anti-PLA2R antibody is closely related to the clinicopathology of IMN,and helps to judge the disease and predict the treatment response.