| Objective To investigate the value of GPI,anti-CCP,anti-MCV and RF in diagnosing RA, providing a new laboratory evidence for the early diagnose,prevention and treatment of rheumatoid arthritis.Methods Established three groups including RA group, the other auto immune disease group and healthy control group. All subjects were collected frompeople’s hospital of Yuxi city from January 2014 to October 2014. The RA group selected 208 cases of patients which come from Rheumatism Haematology Department in hospital and confirmed with RA, They conformed to the diagnostic criteria that the American rheumatism association (ACR) revisioned in 1987. The other self immune disease group selected 103 cases of patients which come from the same department during the same period in our hospital. The healthy control group selected 117 cases of healthy people during the same period in the physical examination in our hospital.1、RF were examined with rate scatter nephelometry in the serum, GPI, anti-CCP, anti-MCV levels were detected by enzyme linked immunosorbent assays (ELI SAs) in the serum.2、Comparing serological levels of single indicator in three groups.3、Analyzing the performance evaluation in RA of single indicator (sensitivity, specificity, positive predictive value, negative predictive value and total consistent rate).4、Drawing ROC curve and calculate the area under the curve, evaluating the value of four indicators in separate and joint detection.5、Analysising the complementary relationship of four indicators in RA group.6、The distriburion of four indicators in DAS28, X-ray stage and extra-articular performance.Results1、GPI levels have significant differences in RA group, non-RA group and healthy control group(F=82.429, P=0.000), RA with the RA group and normal control group with significant difference (P=0.000,P=0.000). Anti-CCP levels have significant differences in RA group, non-RA group and healthy control group (F=32.336, P=0.001), RA with the RA group and normal control group with significant difference (P=0.000, P=0.001). Anti-MCV levels have significant differences in RA group, non-RA group and healthy control group (F=14.969, P=0.005), RA with the RA group and normal control group with significant difference (P=0.004, P=0.003). RF levels have significant differences in RA group, non-RA group and healthy control group (F= 17.324, P=0.003), RA with the RA group and normal control group with significant difference (P=0.021, P=0.001).2、GPI has the highest sensitivity to diagnose RA (83.0%), followed by anti-CCP (76.8%), anti-CCP has the highest specificity (94.1%), followed by GPI (91.4%), the positive predictive value:anti-MCV(91.5%)>GPI(82.1%)> anti-CCP (86.4%)>RF(82.1%),the negative predictive value:RF(82.9%)>GPI(82.1%)>anti-CCP(79.9%)>anti-MCV(78.1%),the performance evaluation in RA:GPI(86.0%) >anti-MCV(81.2%)>anti-CCP(81.1%)>RF(77.4%). Sensitivity, specificity, positi ve predictive value, negative predictive value and total coincidence rate have n o statistical difference of each index to detect RA group (X2=3.383, P=0.279. X2=3.040, P=0.386. X2=5.292, P=0.0.152. X2=0.949, P=0.814. X2=2.675, P=0. 445).3、Drawing ROC cure of each indicator to RA group and non-RA group and calculate the area under the curve:GPI(0.929)>anti-MCV(0.923)>anti-CCP(0.901) >RF(0.880), the indicators of AUC have statistical significance (P=0.001, P=0.001, P=0.001, P=0.030<0.05). By Logistic regression equation model of probability value four curve fitting the AUC is 0.980, there are statistically significant (P=0.001<0.05). After fitting, of the AUC is greater than any single indicator of AUC.4、Other three indexes have certain positive rate when negative single index.5、The distribution have a significant differences of anti-CCP in DAS28,X-ray stage and extra-articular performance(P<0.01).The distribution has no significant difference between GPI, anti-MCV, RF with DAS28, X-ray stage, extra-articular performance (p>0.01).Conclusion The level of GPI, anti-CCP, anti-MCV and RF significantly increased in patients with RA. They are the symbol antibodies of the RA. The performance evaluation of each indicator for RA diagnosis is high. GPI has the highest total coincidence rate. The diagnostic value of each index is yet to be further verified. Joint detection can improve the correct rate of diagnosing RA, especially for clinical atypical or RF, anti CCP negative, they are helpful for the early diagnosis of RA. Anti-CCP is correlated with the disease activity of RA, stage of X-ray and extra articular manifestation in RA patients. |
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