| Journal: | Revista brasileira de reumatologia |
| Database: | PERIÓDICA |
| System number: | 000307042 |
| ISSN: | 0482-5004 |
| Authors: | Silva, Aldifran Ferreira da1 Matos, Afonso Napoleao Lima, Aurea Maria Santana Lima, Elizia Fernandes Gaspar, Antonio Pinheiro Braga, Jose Antonio Fortes2 Carvalho, Edgar M3 |
| Institutions: | 1Universidade Federal do Maranhao, Sao Luis, Maranhao. Brasil 2Laboratorio Gaspar de Sao Luís, Sao Luis, Maranhao. Brasil 3Universidade Federal da Bahia, Salvador, Bahia. Brasil |
| Year: | 2006 |
| Season: | May-Jun |
| Volumen: | 46 |
| Number: | 3 |
| Pages: | 174-180 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Estadística o encuesta |
| Approach: | Analítico |
| English abstract | Rheumatoid arthritis (RA) is one of the most common autoimmune rheumatic diseases, but a specific and reproducible test for its diagnosis is still lacking. OBJECTIVES: To evaluate the diagnostic efficiency of a new commercial ELISA kit in detecting anti-cyclic citrullinated peptide antibodies (anti-CCP) for the diagnosis of RA. METHODS: Anti-CCP antibodies and rheumatoid factor (RF) were determined in the serum of 486 patients: 100 patients with RA and 386 controls, including healthy subjects, patients with other non-rheumatic and rheumatic disease, as well as patients with infections disease. Comparative evaluation of diagnostic performance of anti-CCP and RF was done by calculation the several diagnostic indexes and construction of the ROC (receiver operator characteristic) curve. Statistical analysis included chi-square, Fisher exact, and Mann-Whitney's test. RESULTS: At cutoff of 25 UI/ml, anti-CCP showed sensitivity of 68% (95% CI, 57,8-76,8%), specificity of 97,7% (95% CI, 95,5-98,8%), positive predictive value (VPP) of 88,3% (95% CI, 78,5-94,2%), negative predictive value (VPN) of 92,2% (95% CI, 89-94,5%) and likelihood ratios (LR) of 29,2% (95% CI, 15,1-56,4%). Anti-CCP-positive RA patients had a mean antibody concentration of 920,7 UI/ml (range, 70,5-2000 UI/ml). Anti-CCP-positive non-RA patients had a mean antibody concentration of 38,7 UI/ml (range, 29,5-47, 4 UI/ml). The diagnostic performance of anti-CCP, as estimated by the ROC curve, was superior to that of RF. RF had a higher sensitivity (91%) and a lower specificity (78,8%) than anti-CCP. When the two antibodies were used together, specificity was 99,5%. CONCLUSION: The anti-CCP testing presented the best diagnostic performance for RA and was the most specific test. It may be useful if performance concomitantly with RF in the diagnostic difficulty |
| Portuguese abstract | A artrite reumatóide (AR) é considerada uma das doenças auto-imunes mais freqüentes, mas um teste viável e específico para seu diagnóstico não está disponível. OBJETIVOS: avaliar a eficiência diagnóstica de um novo teste comercial realizado pela técnica de ELISA (Immunoscan RA; EuroDiagnostica), que detecta o anticorpo antipeptídeo citrulinado cíclico (anti-CCP), para o diagnóstico da AR. MÉTODOS: anticorpo anti-CCP e fator reumatóide (FR) foram pesquisados no soro de 486 pacientes: 100 pacientes com AR e 386 controles, incluindo indivíduos normais, pacientes com outras doenças reumáticas e não-reumáticas, bem como pacientes com doenças infecciosas. Avaliação comparativa do desempenho diagnóstico dos testes foi feita mediante cálculo dos diversos índices diagnósticos e da curva ROC (receiver operator characteristic). A análise estatística foi feita utilizando os testes do qui-quadrado, exato de Fisher e Mann-Whitney. RESULTADOS: ao ponto de corte de 25 UI/ml, o anti-CCP apresentou sensibilidade de 68% (IC 95%, 57,8-76,8%), especificidade de 97,7% (IC 95%, 95,5-98,8%), valor preditivo positivo (VPP) de 88,3% (IC 95%, 78,5-94,2%), valor preditivo negativo (VPN) de 92,2% (IC 95%, 89-94,5%) e razão de verossimilhança (RV) de 29,2% (IC 95%, 15,1-56,4%). Os pacientes com AR anti-CCP positivos apresentavam titulação média igual a 920,7 UI/ml (variação, 70,5- 2000 UI/ml). Pacientes não-reumatóides anti-CCP positivos apresentavam titulação média de 38,7 UI/ml (variação, 29,5-47,4 UI/ml). O desempenho do anti-CCP, avaliado atravé |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Reumatología, Artritis reumatoide, Valor diagnóstico, Autoanticuerpos, Anticuerpos anti-péptidos cíclicos citrulinados |
| Keyword: | Medicine, Diagnosis, Rheumatology, Rheumatoid arthritis, Diagnostic value, Autoantibodies, Anti-cyclic citrullinated peptide antibodies |
| Full text: | Texto completo (Ver HTML) |
