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抗环瓜氨酸肽抗体是类风湿关节炎诊断的良好指标。

Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis.

机构信息

Asrul Abdul Wahab, Department of Medical Microbiology & Immunology, Faculty of Medicine, The National University of Malaysia, Cheras 56000 Kuala Lumpur, Malaysia.

Marlyn Mohammad, Department of Medical Microbiology & Immunology, Faculty of Medicine, The National University of Malaysia, Cheras 56000 Kuala Lumpur, Malaysia.

出版信息

Pak J Med Sci. 2013 May;29(3):773-7. doi: 10.12669/pjms.293.2924.

Abstract

OBJECTIVES

Anti-cyclic citrullinated peptide (CCP) antibody has recently been used in the classification of rheumatoid arthritis (RA). This antibody is more specific than rheumatoid factor (RF) for the diagnosis of RA. The study objectives were to determine the sensitivity, specificity, positive and negative predictive values of anti-CCP in RA diagnosis.

METHODOLOGY

Eighty RA patients and 80 non-RA individuals were included in the study. Blood was collected from both arms of study subjects and tested for anti-CCP and RF antibodies. Relevant clinical information and laboratory profiles of the RA patients were evaluated using patients' medical records and Integrated Laboratory Management System (ILMS), respectively. Results : The sensitivity and specificity of anti-CCP were 35% and 100% respectively. The positive and negative predictive values were 100% and 61%, respectively. Positive anti-CCP was found significantly associated with multiple joint pain (p< 0.001) and hand's joints pain (p=0.01), symmetrical joints involvement (p=0.015) and high CRP value (p<0.001). Anti-CCP was also found to have positive association with RF (p<0.001).

CONCLUSION

Anti-CCP is highly specific for the diagnosis of RA. High positive predictive value should be taken into consideration for effective treatment.

摘要

目的

抗环瓜氨酸肽(CCP)抗体最近已被用于类风湿关节炎(RA)的分类。与类风湿因子(RF)相比,该抗体对 RA 的诊断具有更高的特异性。本研究的目的是确定抗 CCP 在 RA 诊断中的敏感性、特异性、阳性和阴性预测值。

方法

本研究纳入 80 例 RA 患者和 80 名非 RA 个体。从研究对象的双臂采集血液,检测抗 CCP 和 RF 抗体。分别使用患者病历和综合实验室管理系统(ILMS)评估 RA 患者的相关临床信息和实验室特征。

结果

抗 CCP 的敏感性和特异性分别为 35%和 100%。阳性和阴性预测值分别为 100%和 61%。阳性抗 CCP 与多关节疼痛(p<0.001)和手部关节疼痛(p=0.01)、对称性关节受累(p=0.015)和高 CRP 值(p<0.001)显著相关。抗 CCP 与 RF 也呈正相关(p<0.001)。

结论

抗 CCP 对 RA 的诊断具有高度特异性。应考虑高阳性预测值以进行有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed5d/3809312/856dd2474867/pjms-29-773-g001.jpg

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