Diagnostic Value Of Anti-mutated Citrullinated Vimentin Antibodies In Early Rheumatoid Arthritis

Rheumatoid arthritis is a common with systemic inflammatory arthritis, the highincidence of genetic family history of disease in women, smokers and people, withglobal distribution. Irreversible joint damage human body to the pathogenesis of RAafter two years, according to relevant statistics, survey in the United States, a battalionof infantry, with RA time of10years,35%patients appeared disability. Therefore, theearly diagnosis of RA, actively provide related treatment, is essential to control theprogress of the disease. Serological index for the diagnosis of early RA has been thefocus of relevant research at home and abroad, the recent discovery of anti-mutatedcitrullinated vimentin (MCV) antibody can appear in early RA, has important clinicalvalue for the early diagnosis of RA.Objectiv: By the early RA patients serum anti-mutated citrullinated vimentinantibody, anti cyclic citrullinated peptide antibodies (CCP) antibody, rheumatoid factor(RF), antiperinuclear factor (APF) and anti-keratin antibody (AKA), to explore thesignificance of serum anti MCV antibody level in the diagnosis of early RA, andcomparative analysis and correlation with antibody to CCP, RF, APF and AKA levels,explore the value of MCV antibody detection in a number of indicators, which is widelyused in clinical practice, especially for the clinical diagnosis of early rheumatoidarthritis.Methods: The subjects were divided into three groups, early RA group, non RAgroup and the healthy control group, early RA group is based on the American Collegeof Rheumatology (ACR) RA diagnostic classification standard was revised in2009,choose2011-2013years in Dalian Friendship Hospital inpatient and outpatient early in40cases of RA patients. In30patients with other autoimmune diseases in patients withnon RA group for the period in this hospital inpatient and outpatient non-RA,including3cases of SLE,12cases of osteoarthritis,6cases of patients with Sjogren’s syndrome,9cases of ankylosing spondylitis. The set of all patients were in accordancewith the diagnostic criteria of diagnosis of the putative autoimmune diseases to thestandard diagnosis. Healthy control group had30cases, all in Dalian Friendship hospitalphysical examination of healthy subjects. All the research object of blood are collectedvenous blood2-4mL is selected, and at about8-9a.m., blood samples were drawnbefore6pm the day after the start of fasting, serum after centrifugation at-80℃preservation for mass detection. Determination of40cases of early RA in sera ofpatients with anti MCV antibody level by ORGENTEC company of Germany, the latestdevelopment and production of Alegria autoimmune automatic quantitative method, andapplication of chemiluminescence detection of antibodies against CCP, enhancedturbidimetric assay for detection of RF, immunofluorescence assay for detection of APFand AKA, were compared with30cases of non RA and30healthy persons.Results: The positive rate of early RA group MCV antibody, CCP antibody, RF,APF, AKA (80%,62.5%,55%,45%and52.5%) were significantly higher than those inRA group (6.7%,13.3%,20%,16.7%and13.3%) and healthy controls (0%,0%,3.3%,0%and0%, P <0.05). The sensitivity of80%, specificity of96.7%, positive predictivevalue of94.1%and anti MCV antibody negative predictive value of87.9%was higherthan that of anti CCP antibody (62.5%,93.3%,86.2%and78.9%), RF (55%,88.3%,75.9%and74.6%), APF (45%,91.7%,78.3%and71.4%) and AKA (52.5%,93.3%,84%and74.7%). The results of correlation analysis showed that, the correlation of antiMCV antibody and anti CCP antibody was the strongest (r=0.542, P<0.01), AKA, RFand APF times (r=0.431,0.396,0.387, P<0.01).Conclusions: The test results show that, the anti MCV antibody in the positivedomain value≥20U/M1was regarded as positive standard, the positive rate ofdiagnosis of early RA group was80%, showed that the anti MCV antibody is valuablein the diagnosis of early RA, can be used as auxiliary diagnosis index for early stage RA.Detection of anti MCV antibody and anti CCP antibody, RF, APF and AKAcomparative analysis of the results shows, the sensitivity and specificity of MCVantibody were higher than the sensitivity and specificity of the antibody against CCP,RF, APF, AKA sensitivity of80%, which was significantly higher than that ofantibodies against CCP, RF, APF and AKA. The results of detection of anti MCVantibody and anti CCP antibody, RF, APF and AKA correlation analysis, the strongestanti MCV antibody and anti CCP antibody correlation (r=0.542, P<0.01), and AKA, RFand APF correlation times. The results show that, the combined detection of more anti MCV antibody and anti CCP antibody, RF, APF and AKA five antibodies contribute tothe clinical diagnosis of early RA, greatly reduce the misdiagnosis and missed diagnosisof early RA, improve the prognosis of patients.