| Objective: To evaluate the diagnostic value of anti-Mutated Citrullinated Vimentin(MCV) antibody, Glucose-6- Phosphate Isomerase(GPI) antigen and Anti-Cyclic Citrullinated Peptides(CCP) antibody in patients with rheumatoid arthritis(RA).Methods: Patients with RA(60), non-RA patients(45) and healthy people(42)attending Weihai Orthopaedic Hospital were randomly recruited for the study. Clinical data were recorded and venous blood was obtained. Serum levels of GPI antigen,anti-MCV antibody and anti-CCP antibody were determined with ELISA.Rate-scattering turbidimetry method was used for detecting RF. The disease activity was graded using DAS28 scoring system. The sensitivity, specificity, positive predictive value and negative predictive value of anti-MCV antibody, GPI, anti-CCP antibody and RF in diagnosing RA were determined, and the correlations of these seral markers with the disease activity was analysed.Results: The average concentrations of anti-MCV antibody, GPI Antigen, anti-CCP antibody and RF in the RA group were 265.7 ±126.15(U/m L), 1.13 ± 0.501(mg/L),721.18 ± 481.29(RU/m L) and 142.23 ± 82.80(U/m L), respectively, which were significantly higher than those of the non-RA group and normal control group(P<0.05). The positive rates of anti-MCV antibody, GPI Antigen, anti-CCP antibody and RF in RA group were significantly higher than those of non-RA group and normal control group(P<0.05) The diagnosis sensitivity of anti-MCV antibody was significantly greater than that of RF(P<0.05).The specificities of GPI antigen and anti-CCP antibody were significantly greater than that of RF(P<0.01, 0.05). The positive predictive value of GPI antigen was significantly greater than that of RF(P<0.05). Combined diagnosis using anti-CCP Ab + RF increased specificity to97.8% which was significantly greater than using anti-MCV Ab or RF alone(P<0.05). Combined diagnosis with anti-MCV Ab + RF showed no significant differences in sensitivity and specificity compared with combined test with anti-CCP Ab + RF(P>0.05).,Combined diagnosis with GPI Ag + anti-CCP Ab + RF further increased specificity to 100%, meanwhile significantly reduced sensitivity compared with all single markers or combined tests in this study(P<0.05). GPI antigen level was positively correlated with DAS28 scores, ESR and CRP values(correlation coefficient 0.712, 0.284 and 0.394, P<0.01-0.05). The serum concentrations of anti-MCV Ab,anti-CCP Ab, GPI Ag and RF in the early stage RA patients were significantly higher than those of non-RA group and normal control group(P<0.05). The positive rate of anti-MCV antibody was significantly higher than that of GPI in the early stage RA patients(P<0.05)Conclusion: Anti-MCV antibody, GPI Antigen and anti- CCP antibody are relatively sensitive and specific serological markers for RA diagnosis Parallel combined diagnosis using GPI Ag + anti-CCP Ab + RF demonstrated higher sensitivity and specificity. GPI antigen can be used for determining disease activity and treatment follow- up. |
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