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目的探讨抗突变型瓜氨酸波形蛋白(mutated citrullinated vimentin,MCV)抗体对类风湿关节炎(rheumatoid arthritis,RA)的临床诊断价值。方法 791例RA患者为RA组,1 369例非RA自身免疫病患者为非RA组,100例体检健康者为对照组,3组采用ELISA法检测血清抗MCV抗体和抗环瓜氨酸多肽(cyclic citrullinated peptide,CCP)抗体水平,分析抗MCV和抗CCP抗体的相关性及其诊断RA的敏感性和特异性。结果 RA组血清抗MCV抗体[(95.1±16.6)RU/mL]和抗CCP抗体水平[(89.3±12.9)RU/mL]明显高于非RA组[(8.8±4.3)、(17.5±5.8)RU/mL](P<0.05)和对照组[(6.8±2.9)、(9.1±3.5)RU/mL](P<0.05),非RA组与对照组比较差异无统计学意义(P>0.05);ROC曲线分析结果显示,抗MCV抗体及抗CCP抗体诊断RA的AUC均为0.95;抗MCV抗体诊断RA的敏感性为82.1%,特异性为97.9%,阳性预测值为95.4%,阴性预测值为91.1%;抗CCP抗体诊断RA的敏感性为78.1%,特异性为98.1%,阳性预测值为94.5%,阴性预测值为90.3%;抗MCV抗体与抗CCP抗体呈正相关(r=0.726,P=0.008)。结论抗MCV抗体与抗CCP抗体诊断RA均有较好的敏感性和特异性,抗MCV抗体敏感性高于抗CCP抗体,可作为诊断RA的有效指标。
Objective To investigate the clinical value of anti-mutant mutated citrullinated vimentin (MCV) antibody in the diagnosis of rheumatoid arthritis (RA). Methods 791 patients with RA were RA group, 1 369 patients with non-RA autoimmune disease were non-RA group, and 100 healthy people were selected as control group. Serum anti-MCV antibody and anti-cyclic citrullinated peptide cyclic citrullinated peptide (CCP) antibody levels and to analyze the association between anti-MCV and anti-CCP antibodies and the sensitivity and specificity of their diagnosis of RA. Results The serum level of anti-MCV antibody (95.1 ± 16.6 RU / mL) and anti-CCP antibody level (89.3 ± 12.9 RU / mL) in RA patients were significantly higher than those in non-RA patients (8.8 ± 4.3 vs 17.5 ± 5.8) There was no significant difference between the non-RA group and the control group (P> 0.05) and the control group (6.8 ± 2.9, 9.1 ± 3.5) RU / mL ). The ROC curve analysis showed that the AUC of anti-MCV antibody and anti-CCP antibody in diagnosis of RA was 0.95. The sensitivity and specificity of anti-MCV antibody in diagnosing RA were 82.1%, 97.9% and 95.4% respectively. The negative predictive value The value of anti-CCP antibody was 78.1%, the specificity was 98.1%, the positive predictive value was 94.5% and the negative predictive value was 90.3%. The anti-MCV antibody was positively correlated with anti-CCP antibody (r = 0.726 , P = 0.008). Conclusion Anti-MCV antibodies and anti-CCP antibodies in the diagnosis of RA have good sensitivity and specificity, anti-MCV antibody sensitivity than anti-CCP antibodies, can be used as a diagnostic indicator of RA.