Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Seoul National University Hospital, Seoul, Korea.
Clin Exp Rheumatol. 2020 Nov-Dec;38(6):1075-1079. Epub 2020 Feb 4.
To evaluate the performance of the 2019 European League against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) in Asian patients.
We conducted an electronic medical chart review of patients with SLE and defined rheumatic diseases. Classification criteria of the 1997 ACR, 2012 Systemic Lupus International Collaborating Clinics (SLICC), and 2019 EULAR/ACR were examined based on sensitivity, specificity, positive predictive value, negative predicted value, and accuracy using clinical diagnosis as the gold standard.
A total of 335 SLE patients and 337 non-SLE patients were analysed. Non-SLE patients included rheumatoid arthritis (RA) (n=92), anti-phospholipid syndrome (APS) (n=57), mixed connective tissue disease (n=52), systemic sclerosis (n=43), primary Sjögren's syndrome (SS) (n=39), undifferentiated connective tissue disease (n=28), RA with secondary SS (n=24), dermatomyositis (n=1), and spondyloarthropathy (n=1). The sensitivity was 97.6% (95% confidence interval (CI): 0.954-0.989) for the 2019 EULAR/ACR criteria, 98.5% (95% CI: 0.966-0.995) for the 2012 SLICC criteria and 95.5% (95% CI: 0.927-0.975) for the 1997 ACR criteria. The specificity was 91.4% (95% CI: 0.879-0.942) for the 2019 EULAR/ACR criteria, 92.6% (95% CI: 0.892-0.951) for the 2012 SLICC criteria 93.8% (95% CI: 0.906-0.961) for the 1997 ACR criteria.
The 2019 EULAR/ACR criteria for SLE had comparable performance to the 2012 SLICC criteria regarding diagnostic sensitivity and specificity in Korean population of SLE and other rheumatic diseases. However, the new criteria could not reach higher specificity than the 2012 SLICC criteria.
评估 2019 年欧洲抗风湿病联盟/美国风湿病学会（EULAR/ACR）系统性红斑狼疮（SLE）分类标准在亚洲患者中的表现。
我们对 SLE 患者和定义明确的风湿病患者进行了电子病历回顾。根据临床诊断作为金标准，检查了 1997 年 ACR、2012 年系统性红斑狼疮国际合作临床（SLICC）和 2019 年 EULAR/ACR 的分类标准的敏感性、特异性、阳性预测值、阴性预测值和准确性。
共分析了 335 例 SLE 患者和 337 例非 SLE 患者。非 SLE 患者包括类风湿关节炎（RA）（n=92）、抗磷脂综合征（APS）（n=57）、混合性结缔组织病（n=52）、系统性硬化症（n=43）、原发性干燥综合征（SS）（n=39）、未分化结缔组织病（n=28）、继发于 SS 的 RA（n=24）、皮肌炎（n=1）和脊柱关节病（n=1）。2019 年 EULAR/ACR 标准的敏感性为 97.6%（95%可信区间[CI]：0.954-0.989），2012 年 SLICC 标准的敏感性为 98.5%（95% CI：0.966-0.995），1997 年 ACR 标准的敏感性为 95.5%（95% CI：0.927-0.975）。2019 年 EULAR/ACR 标准的特异性为 91.4%（95% CI：0.879-0.942），2012 年 SLICC 标准的特异性为 92.6%（95% CI：0.892-0.951），1997 年 ACR 标准的特异性为 93.8%（95% CI：0.906-0.961）。
在韩国 SLE 患者和其他风湿病患者中，2019 年 EULAR/ACR 分类标准在诊断敏感性和特异性方面与 2012 年 SLICC 标准相当。然而，新的标准无法达到比 2012 年 SLICC 标准更高的特异性。
