Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Department of Clinical Laboratory, The First Hospital of Jilin University, Jilin, China.
Int J Rheum Dis. 2021 May;24(5):633-646. doi: 10.1111/1756-185X.14093. Epub 2021 Mar 13.
To evaluate the diagnostic value of anti-citrullinated α-enolase peptide 1 (anti-CEP 1) antibody in patients with rheumatoid arthritis (RA) by conducting a systematic review and meta-analysis.
The PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases were searched for relevant studies published until September 23, 2020. A bivariate mixed-effects model was used to calculate the diagnostic indices from primary data of eligible studies. We performed meta-regression and subgroup analysis to explore the sources of heterogeneity.
Twenty-four articles, with a total of 17 380 patients with RA and 7505 control participants, met the criteria for inclusion in the meta-analysis. The pooled sensitivity, specificity, and positive and negative likelihood ratios for the anti-CEP 1 antibody were 44% (95% CI: 38%-51%), 97% (95% CI: 96%-98%), and 14.81 (95% CI: 10.66-20.57) and 0.57 (95% CI: 0.52-0.64), respectively. The pooled positive and negative predictive values were 0.96 (95% CI: 0.95-0.97) and 0.53 (95% CI: 0.43-0.63), respectively. The area under the summary receiver operating characteristic curve was 0.86. Meta-regression indicated that the anti-CEP 1 antibody detection method may be a source of heterogeneity. The subgroup analysis of the group in which the anti-CEP 1 antibody was detected by using a commercial enzyme-linked immunosorbent assay (ELISA) kit had a sensitivity of 59% (95% CI: 50%-68%) and a specificity of 93% (95% CI: 85%-97%).
The anti-CEP 1 antibody had moderate RA diagnostic value with relatively low sensitivity and high specificity. An ELISA may increase the RA diagnostic sensitivity.
通过系统评价和荟萃分析评估抗瓜氨酸化α-烯醇化酶肽 1（抗 CEP 1）抗体在类风湿关节炎（RA）患者中的诊断价值。
检索PubMed、Web of Science、Embase、Scopus 和 Cochrane Library 数据库，检索截至 2020 年 9 月 23 日的相关研究。使用双变量混合效应模型从合格研究的原始数据计算诊断指标。我们进行了荟萃回归和亚组分析，以探讨异质性的来源。
24 篇文章，共纳入 17380 例 RA 患者和 7505 例对照参与者，符合荟萃分析标准。抗 CEP 1 抗体的合并敏感性、特异性、阳性似然比和阴性似然比分别为 44%（95%CI：38%-51%）、97%（95%CI：96%-98%）、14.81（95%CI：10.66-20.57）和 0.57（95%CI：0.52-0.64）。合并阳性和阴性预测值分别为 0.96（95%CI：0.95-0.97）和 0.53（95%CI：0.43-0.63）。汇总受试者工作特征曲线下面积为 0.86。荟萃回归表明，抗 CEP 1 抗体的检测方法可能是异质性的来源。使用商业酶联免疫吸附测定（ELISA）试剂盒检测抗 CEP 1 抗体的亚组分析显示敏感性为 59%（95%CI：50%-68%），特异性为 93%（95%CI：85%-97%）。
抗 CEP 1 抗体对 RA 具有中等诊断价值，敏感性相对较低，特异性较高。ELISA 可能会提高 RA 的诊断敏感性。
