抗MCV抗体、抗CCP抗体对类风湿关节炎的诊断价值及其与疾病活动度的相关性OACSTPCD

Objective To investigate the diagnostic value of anti-mutated citrullinated vimentin(MCV)antibody and anti-cyclic citrullinated peptide(CCP)antibody on rheumatoid arthritis(RA),and to analyze their correlations with disease activity of RA.Methods A total of 74 RA patients(the RA group),95 patients with connective tissue disease(the non-RA group),and 60 healthy check-up individuals(the healthy control group)were selected as the research subjects.Patients of the RA group were assigned to high-activity stage group(n=22),medium-activity stage group(n=18),low-activity stage group(n=14),or remission stage group(n=20)based on Disease Activity Score in 28 Joints-Erythrocyte Sedimentation Rate(DAS28-ESR).The positive rates of serum anti-MCV antibody,serum anti-CCP antibody,serum rheumatoid factor(RF),and ESR were compared between the RA group,the non-RA group and the healthy control group,as well as serum anti-MCV antibody level,serum anti-CCP antibody level,serum RF level,and ESR were compared between the groups of RA with different activity stages.The receiver operating characteristic curve was drawn to analyze the values of serum anti-MCV antibody level,serum anti-CCP antibody level,serum RF level,and ESR for alone and jointly diagnosing RA.The correlations of serum anti-MCV antibody level,serum anti-CCP antibody level,serum RF level,and ESR with DAS28-ESR were analyzed.Results(1)The RA group exhibited higher positive rates of serum anti-MCV antibody,serum anti-CCP antibody,serum RF,and ESR as compared with the non-RA group and the healthy control group(P<0.05).The non-RA group yielded higher positive rates of serum anti-CCP antibody,serum RF,and ESR as compared with the healthy control group(P<0.05),but there was no statistically significant difference in serum anti-MCV antibody positive rate between the two groups(P>0.05).(2)Serum anti-MCV antibody and serum anti-CCP antibody levels,as well as ESR were elevated successively in the remission stage group,and the low-,medium-and high-activity stage groups(P<0.05);furthermore,the high-activity stage group interpreted a higher serum RF level as compared with the remaining 3 groups(P<0.05),but there was no statistically significant difference in serum RF level between the remaining 3 groups(P>0.05).(3)Areas under the curve(AUC)of serum anti-MCV antibody and serum anti-CCP antibody levels for alone diagnosing RA were all larger than 0.85,and all larger than AUC of serum RF level and ESR(P<0.05).There was no statistically significant difference in sensitivity,specificity,and AUC between serum anti-MCV antibody level and serum anti-CCP antibody level for diagnosing RA(P>0.05);furthermore,AUC of serum anti-MCV antibody level,serum anti-CCP antibody level,serum RF level,and ESR for jointly diagnosing RA reached 0.935,which was larger than AUC of any single index for diagnosing RA(P<0.05).(4)Serum anti-MCV antibody and serum anti-CCP antibody levels,as well as ESR all positively correlated with DAS28-ESR in RA patients(P<0.05).Conclusion Compared with conventional indices in terms of serum RF and ESR,both serum anti-MCV antibody and serum anti-CCP antibody exert relatively high diagnostic values for RA,and the two combined with serum RF and ESR for diagnosing RA can significantly improve diagnostic efficiency.Serum anti-MCV antibody level and serum anti-CCP antibody level positively correlate with RA disease activity,which can be regarded as adjuvant indices for evaluating patients'disease activity.