Diagnostic Value of Autoantibodies Against Citrullinated Peptide Antigens in Rheumatoid Arthritis: Comparison of Different Commercial Kits

摘要

Objectives: In this study we tested the diagnostic values ofrheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP)and two different commercial anti-mutated citrullinated vimentin(anti-MCV) kits in the differential diagnosis of rheumatoid arthritis(RA) considering that there might also be substantial differencesbetween the performances of the commercial kits.Patients and methods: T hirty-four R A p atients, a dmitted t oour rheumatology outpatient clinics between October 2008 andFebruary 2009, and 24 healthy controls were included in this study.Sera of RA patients and healthy controls were analyzed for RF,anti-CCP-2, anti-MCV-548 and anti-MCV-248 autoantibodies withtwo different commercial kits. Disease activity was determined bydisease activity score 28 (DAS-28) in RA patients. Extra-articularinvolvement was evaluated in RA patients.Results: In the receiver operating characteristic (ROC) curveanalysis perfomed to determine the diagnostic sensitivity, anti-CCP-2 had the highest value of area under ROC curve. Sensitivityand specificity was 88% and 90%, 84% and 100%, 80% and90%, and 84% and 100% for RF, anti-CCP-2, anti-MCV-548, andanti-MCV-248 respectively. DAS-28 had a weak correlation withanti-CCP-2 (r=0.623), anti-MCV-548 (r=0.481), and Anti-MCV-248(r=0.408). There was no statistically significant difference in RF,anti-CCP-2, anti-MCV-548, and anti-MCV-248 values betweenpatients with or without extra-articular involvement or betweenpatients with low or moderate disease activity according toDAS-28 score.Conclusion: A nti-CCP, R F a nd a nti-MCV a utoantibodies a re a lluseful in the differential diagnosis of RA. However, the anti-CCPantibody has a superior diagnostic value compared to the otherautoantibodies. The anti-MCV antibodies detected by the anti-MCV-248 kit seem more reliable than the anti-MCV antibodiesdetected by the anti-MCV-548 kit in differential diagnosis of RAdue to their high sensitivity and specificity. These findings suggestthat different commercial kits may exhibit different performances.Nevertheless, our results need to be confirmed by future studieswhich should include more patients.