The Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor Isotypes for Rheumatoid Arthritis_West China Medical Journal

Authors：

YAN Li , HUANG Jiaqin , WANG Mingquan , CAI Deyan.

Department of Clinical Laboratory, the First People’s Hospital of Yibin, Yibin, Sichuan 644000, P. R. China;

Corresponding author：

Keywords：

抗环瓜氨酸肽抗体; 类风湿因子; 类风湿性关节炎; 类风湿因子分型; 诊断效能

DOI：

10.7507/1002-0179.20130589

Video：

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目的　探讨抗环瓜氨酸肽抗体（anti-CCP）与类风湿因子（RF）对类风湿关节炎（RA）的诊断效能，及RF分型检测在RA活动度判断中的价值。方法　选取2012年3月－2013年2月就诊的64例RA患者为病例组，103例其他自身免疫性疾病患者为对照组，用酶联免疫吸附试验分别检测anti-CCP和RF-IgM/IgG/IgA，收集数据进行统计分析。结果　anti-CCP与RF联合指标对RA的诊断灵敏度最高（92.2%），anti-CCP的特异度最高（95.1%）；RF-IgA的水平与骨关节侵蚀程度呈正相关（rs=0.987，P=0.000）；RF的3个亚型都可反映RA疾病的活动度（P＜0.05）。结论　anti-CCP与RF联合诊断RA，可显著提高诊断灵敏度，RF的分型检测对于RA患者的活动度监测有重要价值。

Citation： YAN Li,HUANG Jiaqin,WANG Mingquan,CAI Deyan.. The Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor Isotypes for Rheumatoid Arthritis. West China Medical Journal, 2013, 28(12): 1865-1867. doi: 10.7507/1002-0179.20130589 Copy

1.	Block DR, Jenkins SM, Dalenberg DA, et al. Analytical and clinical comparison of anti-CCP assays with rheumatoid factor for the diagnosis of rheumatoid arthritis[J]. Clin Chim Acta, 2012, 413 (11-12): 1015-1017.
2.	Chen HA, Lin KC, Chen CH, et al. The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2006, 65(1): 35-39.
3.	Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324.
4.	中华医学会风湿病学分会. 类风湿关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(4): 265-270.
5.	Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis[J]. Autoimmune Dis, 2011(2011): 815038.
6.	Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis[J]. Mikrobiyol Bul, 2003, 37(2-3): 163-170.
7.	Agrawal S, Misra R, Aggarwal A. Autoantibodies in rheumatoid arthritis: association with severity of disease in established RA[J]. Clin Rheumatol, 2007, 26(2): 201-204.
8.	Hayashi N, Nishimura K, Kumagai S. New biomarkers for rheumatoid arthritis[J]. Rinsho Byori, 2008, 56(4): 297-308.
9.	Heidari B, Firouzjahi A, Heidari P, et al. The prevalence and diagnostic performance of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: the predictive and discriminative ability of serum antibody level in recognizing rheumatoid arthritis[J]. Ann Saudi Med, 2009, 29(6): 467-470.
10.	Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis[J]. Ann Intern Med, 2007, 146(11): 797-808.
11.	Gao F, Ren L, Zhang CQ, et al. Diagnostic value of anti-cyclic citrullinated peptide antibody for rheumatoid arthritis in a Chinese population: a meta-analysis[J]. Rheumatol Int, 2012, 32(10): 3201-3218.
12.	Eberhardt KB, Truedsson L, Pettersson H, et al. Disease activity and joint damage progression in early rheumatoid arthritis: relation to IgG, IgA, and IgM rheumatoid factor[J]. Ann Rheum Dis, 1990, 49(11): 906-909.
13.	Houssien DA, Jónsson T, Davies E, et al. Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens[J]. Scand J Rheumatol, 1998, 27(1): 46-53.
14.	Ärlestig L, Mullazehi M, Kokkonen H, et al. Antibodies against cyclic citrullinated peptides of IgG, IgA and IgM isotype and rheumatoid factor of IgM and IgA isotype are increased in unaffected members of multicase rheumatoid arthritis families from northern Sweden[J]. Ann Rheum Dis, 2012, 71(6): 825-829.
15.	Hjeltnes G, Hollan I, Førre Ø, et al. Anti-CCP and RF IgM: predictors of impaired endothelial function in rheumatoid arthritis patients[J]. Scand J Rheumatol, 2011, 40(6): 422-427.
16.	Newkirk MM, Goldbach-Mansky R, Senior BW, et al. Elevated levels of IgM and IgA antibodies to Proteus mirabilis and IgM antibodies to Escherichia coli are associated with early rheumatoid factor (RF)-positive rheumatoid arthritis[J]. Rheumatology (Oxford), 2005, 44(11): 1433-1441.

1. 　Block DR, Jenkins SM, Dalenberg DA, et al. Analytical and clinical comparison of anti-CCP assays with rheumatoid factor for the diagnosis of rheumatoid arthritis[J]. Clin Chim Acta, 2012, 413 (11-12): 1015-1017.
2. 　Chen HA, Lin KC, Chen CH, et al. The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2006, 65(1): 35-39.
3. 　Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324.
4. 　中华医学会风湿病学分会. 类风湿关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(4): 265-270.
5. 　Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis[J]. Autoimmune Dis, 2011(2011): 815038.
6. 　Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis[J]. Mikrobiyol Bul, 2003, 37(2-3): 163-170.
7. 　Agrawal S, Misra R, Aggarwal A. Autoantibodies in rheumatoid arthritis: association with severity of disease in established RA[J]. Clin Rheumatol, 2007, 26(2): 201-204.
8. 　Hayashi N, Nishimura K, Kumagai S. New biomarkers for rheumatoid arthritis[J]. Rinsho Byori, 2008, 56(4): 297-308.
9. 　Heidari B, Firouzjahi A, Heidari P, et al. The prevalence and diagnostic performance of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: the predictive and discriminative ability of serum antibody level in recognizing rheumatoid arthritis[J]. Ann Saudi Med, 2009, 29(6): 467-470.
10. 　Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis[J]. Ann Intern Med, 2007, 146(11): 797-808.
11. 　Gao F, Ren L, Zhang CQ, et al. Diagnostic value of anti-cyclic citrullinated peptide antibody for rheumatoid arthritis in a Chinese population: a meta-analysis[J]. Rheumatol Int, 2012, 32(10): 3201-3218.
12. 　Eberhardt KB, Truedsson L, Pettersson H, et al. Disease activity and joint damage progression in early rheumatoid arthritis: relation to IgG, IgA, and IgM rheumatoid factor[J]. Ann Rheum Dis, 1990, 49(11): 906-909.
13. 　Houssien DA, Jónsson T, Davies E, et al. Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens[J]. Scand J Rheumatol, 1998, 27(1): 46-53.
14. 　Ärlestig L, Mullazehi M, Kokkonen H, et al. Antibodies against cyclic citrullinated peptides of IgG, IgA and IgM isotype and rheumatoid factor of IgM and IgA isotype are increased in unaffected members of multicase rheumatoid arthritis families from northern Sweden[J]. Ann Rheum Dis, 2012, 71(6): 825-829.
15. 　Hjeltnes G, Hollan I, Førre Ø, et al. Anti-CCP and RF IgM: predictors of impaired endothelial function in rheumatoid arthritis patients[J]. Scand J Rheumatol, 2011, 40(6): 422-427.
16. 　Newkirk MM, Goldbach-Mansky R, Senior BW, et al. Elevated levels of IgM and IgA antibodies to Proteus mirabilis and IgM antibodies to Escherichia coli are associated with early rheumatoid factor (RF)-positive rheumatoid arthritis[J]. Rheumatology (Oxford), 2005, 44(11): 1433-1441.

West China Medical Journal

The Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor Isotypes for Rheumatoid Arthritis

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