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抗瓜氨酸化α-烯醇化酶肽1抗体在类风湿关节炎诊断中的价值评估

Evaluation of the Value of Anti-Citrullinated α-enolase Peptide 1 Antibody in the Diagnosis of Rheumatoid Arthritis.

作者信息

Zhou Jiansuo, Feng Limei, Zhang Hua, Wang Tiancheng, Cui Liyan

机构信息

Department of Laboratory Medicine, Peking University Third Hospital.

The Research Center of Clinical Epidemiology of Peking University Third Hospital, Beijing, China.

出版信息

Ann Clin Lab Sci. 2019 Sep;49(4):503-506.

Abstract

GOALS

Rheumatoid arthritis (RA) is a chronic inflammatory joint disease. The α enolase is a nuclear glycolytic enzyme. Antibodies to citrullinated-enolase peptide1(anti-CEP-1) are found in approximately 40% of patients with RA, but the diagnostic value of anti-CEP-1 for RA is not clear.

METHODS

We enrolled 282 patients with RA according to the 2010 ACR Classification criteria, referred to the department of Rheumatology in Peking University Third Hospital, 120 sex- and age-matched healthy donors (HD), and 30 patients with osteoarthritis (OA). Anti-CEP-1 IgG antibodies were assessed with a commercially available ELISA kit (Euroimmun, Germany) according to the manufacturers' instructions. Anti-CCP antibodies were assessed with ECLIA (Roche, Germany). Data was processed with SPSS 19. The scatter diagram was drawn in GraphPad Prism.

RESULTS

The specificity and sensitivity was 83.3% and 65.2%, respectively. The positive predictive value was 88% and the negative predictive value was 56%. The AUC of anti-CEP1 for diagnosis of RA is 0.80, while that of Anti-CCP is 0.919; the value of anti-CCP combined with anti-CEP1 is 0.914. Ten anti-CEP1 positive results are found in 48 patients of RA with anti-CCP negative result.

CONCLUSION

The anti-CEP-1 is suitable for diagnosing of RA, but not superior to anti-CCP.

摘要

目的

类风湿关节炎(RA)是一种慢性炎症性关节疾病。α烯醇化酶是一种核糖酵解酶。约40%的RA患者体内可检测到抗瓜氨酸化烯醇化酶肽1抗体(抗CEP-1),但其对RA的诊断价值尚不清楚。

方法

依据2010年美国风湿病学会(ACR)分类标准,纳入北京大学第三医院风湿免疫科的282例RA患者、120例年龄和性别匹配的健康对照者(HD)以及30例骨关节炎(OA)患者。按照制造商说明书,采用市售酶联免疫吸附测定(ELISA)试剂盒(德国欧蒙公司)检测抗CEP-1 IgG抗体。采用电化学发光免疫分析(ECLIA,德国罗氏公司)检测抗环瓜氨酸肽(抗CCP)抗体。数据用SPSS 19软件处理,散点图用GraphPad Prism软件绘制。

结果

抗CEP-1的特异性和敏感性分别为83.3%和65.2%。阳性预测值为88%,阴性预测值为56%。抗CEP1诊断RA的曲线下面积(AUC)为0.80,抗CCP的AUC为0.919;抗CCP联合抗CEP1的AUC为0.914。在48例抗CCP阴性的RA患者中,有10例抗CEP1结果为阳性。

结论

抗CEP-1适用于RA的诊断,但不优于抗CCP。

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