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为了评价类风湿因子(RF)和抗CCP抗体阴性的关节炎患者就诊时血清轻链λ水平对类风湿关节炎(RA)的诊断价值,回顾性分析我院住院RA患者的临床资料,获取患者初诊的RF、抗环瓜氨酸肽(CCP)抗体、免疫球蛋白(Ig)和轻链等数据。根据RF和抗CCP抗体水平,RA患者分为自身抗体阴性组和阳性组。将血清阴性RA患者作为实验组,与非RA关节炎患者构成的对照组进行比较,用受试者工作特征曲线(ROC)和多元Logistic回归分析轻链λ对RA患者诊断的临床价值。结果显示,实验组较对照组关节炎患者的轻链λ水平升高,差异具有统计学意义(P=0.026);ROC分析表明轻链λ对关节炎患者发展为RA具有预测价值,曲线下面积(AUC)达到0.665[95%CI(0.518,0.812)];以620.5mg/dl为临界值,预测RA的敏感性为0.565(0.345,0.768),特异性为0.804(0.661,0.906);多元Logistic回归校正后轻链λ仍然与关节炎患者发生RA相关(OR=3.551,P=0.037)。研究结果表明,血清轻链λ水平对关节炎患者发展为RA具有一定的预测价值。
To evaluate the diagnostic value of serum light chain lambda in patients with rheumatoid arthritis (RA) who have rheumatoid factor (RF) and anti-CCP antibody-negative arthritis, we retrospectively analyzed the clinical data of patients with RA in our hospital for patients RF, anti-cyclic citrullinated peptide (CCP) antibody, immunoglobulin (Ig), and light chain were analyzed. According to the level of RF and anti-CCP antibody, RA patients were divided into autoantibody negative group and positive group. The seronegative RA patients were used as the experimental group and compared with the non-RA arthritis patients. The ROC and multivariate logistic regression analysis were used to analyze the clinical value of light chain λ in diagnosing RA patients. The results showed that the experimental group compared with the control group patients with arthritis increased light chain lambda levels, the difference was statistically significant (P = 0.026); ROC analysis showed that light chain λ in patients with arthritis development of RA has a predictive value, the area under the curve (AUC) of 0.665 [95% CI (0.518, 0.812)]. The sensitivity of RA was 0.565 (0.345,0.768) and specificity was 0.804 (0.661,0.906) with 620.5mg / dl as the cutoff value. After regression, the light chain lambda was still associated with RA in patients with arthritis (OR = 3.551, P = 0.037). The results show that the level of serum light chain of patients with arthritis development of RA has some predictive value.