Original Article
Application of combined detection of anti-CCP, RF, and AKA in the diagnosis of rheumatoid arthritis
Zhang Yuan, Zhang Yinmei, Cui Liyan, Yang Shuo, Zhang Jie
Published 2014-08-11
Cite as Chin J Lab Med, 2014,37(08): 582-586. DOI: 10.3760/cma.j.issn.1009-9158.2014.08.007
Abstract
ObjectiveTo investigate the application of combined detection of three serum markers, anti-cyclic citrullinated peptide antibody (anti-CCP), rheumatoid factor (RF), anti-keratin antibodies (AKA), for the diagnosis of rheumatoid arthritis.
MethodsThis was a prospective study.Serum samples were randomly obtained from 137 RA patients, 265 other autoinmmune diease patients, and 111 normal controls.All of the volunteers were outpatients or inpatients of Peking University Third Hospital from January 2011 to September 2013.Levels of AKA, anti-CCP antibody, RF were measured by indirect immunofluorescence, chemiluminescence, and immune turbidimetry, respectively.The values of 3 serum biomarkers and their varied combinations for RA diagnosis were systemically assessed.The results were compared using fourfold table chi-square (χ2) test.
ResultsWhen using one serum marker, anti- CCP had the highest accuracy (80.39%), Youden′s index (YI) (0.51), and Kappa (κ) value (0.55) for the diagnosis of RA. While using three serum markers, anti-CCP+(AKA/RF), AKA /(anti-CCP+RF), anti-CCP/(AKA+RF) and (AKA+RF)/(anti-CCP+RF)/(AKA+anti-CCP) had the highest accuracy (80.94,80.94,80.66), YI (0.51,0.51,0.50), and κ value (0.55,0.56,0.54).
ConclusionAnti-CCP is the vital marker for RA diagnosis. Anti-CCP+(AKA/RF), AKA/(anti-CCP+RF), and (AKA+RF)/(anti-CCP+RF)/(AKA+anti-CCP) are the most ideal combinations for RA diagnosis. (Chin J Lab Med,2014,37: 582-586)
Key words:
Arthritis, rheumatoid; Autoantibodies; Peptides, cyclic; Keratins; Rheumatoid factor
Contributor Information
Zhang Yuan
Laboratory Medicine Department, Peking University Third Hospital, Beijing 100191,China
Zhang Yinmei
Cui Liyan
Yang Shuo
Zhang Jie