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抗Sa抗体与抗环瓜氨酸肽抗体在类风湿关节炎中的诊断价值比较。

Diagnostic value of the anti-Sa antibody compared with the anti-cyclic citrullinated peptide antibody in rheumatoid arthritis.

作者信息

Iwaszkiewicz Cezary, Puszczewicz Mariusz, Białkowska-Puszczewicz Grażyna

机构信息

Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland.

出版信息

Int J Rheum Dis. 2015 Jan;18(1):46-51. doi: 10.1111/1756-185X.12544. Epub 2014 Dec 8.

Abstract

AIM

To evaluate the prevalence and diagnostic significance of the autoantibody against citrullinated vimentin (anti-Sa) compared with the widely used anti-cyclic citrullinated peptide autoantibody (anti-CCP) in patients with rheumatoid arthritis (RA).

METHOD

One hundred and sixty-nine patients hospitalized at the Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland, were enrolled in a cross-sectional study and divided into two groups. The RA group comprised 41 patients diagnosed as having RA. The non-RA control group included 128 individuals with a variety of rheumatic disorders. Serum anti-Sa and anti-CCP measurements were performed by enzyme-linked immunosorbent assay.

RESULTS

The sensitivity and specificity of anti-Sa for the diagnosis of RA was 36.6% and 96.9%, respectively. For the anti-CCP test, the sensitivity was 65.9% and the specificity was 95.3%. Concomitant presence of anti-Sa and anti-CCP was determined in 36.6% of the patients with RA, whereas isolated positivity of anti-Sa was not observed. Anti-Sa positive RA patients had significantly higher anti-CCP levels compared to anti-Sa negative subjects (P < 0.05).

CONCLUSION

With regard to the relatively low diagnostic sensitivity and the lack of cases identified by anti-Sa alone, we were unable to demonstrate any additional diagnostic value of the anti-Sa autoantibody in comparison to the anti-CCP autoantibody. To the authors' best knowledge, this is the first study among Polish patients verifying the clinical utility of anti-Sa in the diagnosis of RA.

摘要

目的

在类风湿关节炎(RA)患者中,评估与广泛使用的抗环瓜氨酸肽自身抗体(抗CCP)相比,抗瓜氨酸波形蛋白自身抗体(抗Sa)的患病率及诊断意义。

方法

波兰波兹南医科大学风湿病与内科收治的169例患者纳入一项横断面研究,并分为两组。RA组包括41例确诊为RA的患者。非RA对照组包括128例患有各种风湿性疾病的个体。采用酶联免疫吸附测定法检测血清抗Sa和抗CCP。

结果

抗Sa诊断RA的敏感性和特异性分别为36.6%和96.9%。抗CCP检测的敏感性为65.9%,特异性为95.3%。36.6%的RA患者同时存在抗Sa和抗CCP,而未观察到抗Sa单独阳性的情况。与抗Sa阴性的受试者相比,抗Sa阳性的RA患者抗CCP水平显著更高(P<0.05)。

结论

鉴于抗Sa诊断敏感性相对较低且未发现单独由抗Sa确诊的病例,与抗CCP自身抗体相比,我们无法证明抗Sa自身抗体具有任何额外的诊断价值。据作者所知,这是在波兰患者中验证抗Sa在RA诊断中临床效用的第一项研究。

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