Meta-analysis: Diagnostic Accuracy Of Anti-cyclic Citrullinated Peptide2Antibody And Anti-cyclic Citrullinated Peptide3Antibody In Rheumatoid Arthritis

ObjectivesTo assess the diagnostic value of anti-CCP-3and anti-CCP-2forrheumatoid arthritis and determine whether anti-CCP-3more accuratelyidentifies patients with rheumatoid arthritis than anti-CCP-2.MethodPubMed and CNKI databases for studies published in English andChinese that examined anti-CCP-3and anti-CCP-2in the diagnosis ofknown or suspected rheumatoid arthritis from January2006to July2013.17included studies of methodological quality were rated by usingQUADAS tools. A random-effects method was used to summarizesensitivities, specificities, LR+, LR-and DOR from17studies.ResultsThe pooled sensitivity, specificity, LR+, LR-and DOR for anti-CCP-3were0.737(95%CI,0.717to0.757),0.933(95%CI,0.924to0.942),11.096(95%CI,8.876to13.870),0.274(95%CI,0.231to0.326), and42.908(95%CI,33.828to54.426), respectively. For anti-CCP-2, the valueswere0.719(95%CI,0.699to0.739),0.960(95%CI,0.953to0.966),17.485(95%CI,11.960to25.562),0.294(95%CI,0.258to0.335) and63.458(95%CI,44.214to91.078). ConclusionsWith high specificity and moderate sensitivity, anti-CCP-2and anti-CCP-3played an important role in confirming the diagnosis of RA. Anti-CCP-3had no better diagnostic performances than the anti-CCP-2but anti-CCP-2exist evident heterogeneity than anti-CCP-3, especially in Americanpatients.