Bas S, Perneger T V, Seitz M, Tiercy J-M, Roux-Lombard P, Guerne P A
Division of Rheumatology, Department of Internal Medicine, University Hospital, Geneva, Switzerland.
Rheumatology (Oxford). 2002 Jul;41(7):809-14. doi: 10.1093/rheumatology/41.7.809.
To examine the value of anti-cyclic citrullinated peptide (anti-CCP) antibodies, anti-keratin antibodies (AKA) and immunoglobulin M rheumatoid factors (IgM RF) in discriminating between rheumatoid arthritis (RA) and other rheumatic diseases, and to determine whether the clinical manifestations or severity of erosions in RA are associated with anti-CCP positivity.
In a cross-sectional study, we determined the concentrations or titres of these three markers in 179 RA patients and 50 controls. Erosions were quantified using the Larsen score in 129 patients.
Sensitivity was highest for IgM RF (75%), followed by anti-CCP antibodies (68%) and AKA (46%). Specificity was highest for anti-CCP antibodies (96%), followed by AKA (94%) and IgM RF (74%). A correlation with clinical manifestations and severity of erosions was observed mainly for IgM RF positivity.
With their excellent specificity, anti-CCP antibodies can be useful in establishing the diagnosis of RA, but IgM RF is a better predictor of disease severity.
探讨抗环瓜氨酸肽（anti-CCP）抗体、抗角蛋白抗体（AKA）和免疫球蛋白M类风湿因子（IgM RF）在鉴别类风湿关节炎（RA）与其他风湿性疾病中的价值，并确定RA中侵蚀的临床表现或严重程度是否与抗CCP阳性相关。
在一项横断面研究中，我们测定了179例RA患者和50例对照者这三种标志物的浓度或滴度。使用Larsen评分对129例患者的侵蚀情况进行量化。
IgM RF的敏感性最高（75%），其次是抗CCP抗体（68%）和AKA（46%）。抗CCP抗体的特异性最高（96%），其次是AKA（94%）和IgM RF（74%）。主要观察到IgM RF阳性与侵蚀的临床表现和严重程度相关。
抗CCP抗体具有出色的特异性，可用于确立RA的诊断，但IgM RF是疾病严重程度的更好预测指标。
