Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine.
School of Public Health, Nanchang University, Nanchang, China.
Lab Med. 2021 Jan 4;52(1):80-85. doi: 10.1093/labmed/lmaa040.
To investigate the clinical value of detecting anti-mutated citrullinated vimentin (anti-MCV), anti-citrullinated peptide (anti-CCP), red-blood-cell distribution width (RDW), and 25-hydroxyvitamin D (25-[OH]D) in the diagnosis of rheumatoid arthritis (RA).
We enrolled 119 patients with RA, 114 control individuals without RA (disease controls), and 40 healthy controls in our study (Han Chinese). Anti-CCP and anti-MCV were detected by enzyme-linked immunosorbent assay (ELISA), 25-(OH)D was detected by electrochemical luminescence, and RDW was calculated by erythrocyte parameters detected via the electric resistance method.
The serum levels of anti-CCP and anti-MCV in RA were higher than those in disease controls and healthy controls (P <.01). The areas under the curve (AUCs) of anti-MCV, anti-CCP, RDW, and 25-(OH)D were 0.857, 0.890, 0.611, and 0.569 respectively (P <.05). In various combinations of indicators, when RDW, 25-(OH)D, and anti-CCP; or RDW, 25-(OH)D, anti-CCP, and anti-MCV were connected in parallel, the sensitivity was the highest (all 94.1%). Also, when RDW, 25-(OH)D, anti-CCP, and anti-MCV were connected in series, the sensitivity was the lowest (13.4%).
Anti-CCP and anti-MCV are ideal indices for RA diagnosis. Also, in combination with RDW and 25-(OH)D, the diagnostic level will be improved, as well as the sensitivity and specificity, which is significant for the differential diagnosis of RA.
探讨抗突变型瓜氨酸波形蛋白(anti-MCV)、抗环瓜氨酸肽(anti-CCP)、红细胞分布宽度(RDW)和 25-羟维生素 D(25-(OH)D)检测在类风湿关节炎(RA)诊断中的临床价值。
纳入了 119 例 RA 患者、114 例无 RA 的疾病对照者和 40 例健康对照者(汉族人)。采用酶联免疫吸附试验(ELISA)检测抗-CCP 和抗-MCV,电化学发光法检测 25-(OH)D,通过电阻法检测红细胞参数计算 RDW。
RA 患者血清抗-CCP 和抗-MCV 水平高于疾病对照者和健康对照者(P<0.01)。抗-MCV、抗-CCP、RDW 和 25-(OH)D 的曲线下面积(AUCs)分别为 0.857、0.890、0.611 和 0.569(P<0.05)。在各种指标组合中,当 RDW、25-(OH)D 和抗-CCP 并联;或 RDW、25-(OH)D、抗-CCP 和抗-MCV 串联时,敏感性最高(均为 94.1%)。而当 RDW、25-(OH)D、抗-CCP 和抗-MCV 串联时,敏感性最低(13.4%)。
抗-CCP 和抗-MCV 是 RA 诊断的理想指标。同时,与 RDW 和 25-(OH)D 联合应用,可提高诊断水平及敏感性和特异性,对 RA 的鉴别诊断具有重要意义。