Department of Laboratory Medicine, General Hospital of Jinan Military Area, Jinan, Shandong 250031, China.
Department of Laboratory Medicine, Jinan Central Hospital, Jinan, Shandong 250013, China.
J Immunol Res. 2015;2015:915276. doi: 10.1155/2015/915276. Epub 2015 Feb 19.
To estimate the diagnostic accuracy of the anti-CCP test in JIA and to evaluate factors associated with higher accuracy.
Two investigators performed an extensive search of the literature published between January 2000 and January 2014. The included articles were assessed by the Quality Assessment of Diagnostic Accuracy Studies tool. The meta-analysis was performed using a summary ROC (SROC) curve and a bivariate random-effect model to estimate sensitivity and specificity across studies.
The bivariate meta-analysis yielded a pooled sensitivity and specificity of 10% (95% confidence interval (CI): 6.0%-15.0%) and 99.0% (95% CI: 98.0%-100.0%). The area under the SROC curve was 0.96. Sensitivity estimates were highly heterogeneous, which was partially explained by the higher sensitivity in the rheumatoid factor-positive polyarthritis (RF+ PA) subtype (48.0%; 95% CI: 31.0%-65.0%) than in the other subtypes (17.0%; 95% CI: 14.0%-20.0%) and the higher sensitivity of the Inova assay (17.0%; 95% CI: 14.0%-20.%%) than the other assays (0.05%; 95% CI: 2.0%-11.0%).
Anti-CCP antibody test has a high specificity for the diagnosis of JIA. The sensitivity of this test is low and varies across populations but is higher in RF+ PA than in other JIA subtypes.
评估抗 CCP 试验在 JIA 中的诊断准确性，并评估与更高准确性相关的因素。
两位研究者对 2000 年 1 月至 2014 年 1 月期间发表的文献进行了广泛搜索。使用诊断准确性研究质量评估工具评估纳入的文章。使用汇总 ROC（SROC）曲线和双变量随机效应模型进行荟萃分析，以估计研究间的敏感性和特异性。
双变量荟萃分析得出的合并敏感性和特异性分别为 10%（95%置信区间（CI）：6.0%-15.0%）和 99.0%（95%CI：98.0%-100.0%）。SROC 曲线下面积为 0.96。敏感性估计值高度异质，部分原因是类风湿因子阳性多关节炎（RF+PA）亚型的敏感性较高（48.0%；95%CI：31.0%-65.0%），而其他亚型的敏感性较低（17.0%；95%CI：14.0%-20.0%），Inova 检测法的敏感性较高（17.0%；95%CI：14.0%-20.0%），而其他检测法的敏感性较低（0.05%；95%CI：2.0%-11.0%）。
抗 CCP 抗体试验对 JIA 的诊断具有很高的特异性。该试验的敏感性较低，且在不同人群中有所差异，但在 RF+PA 中高于其他 JIA 亚型。
