抗氨基甲酰化蛋白抗体对类风湿关节炎诊断价值的Meta分析

Meta analysis of anti-carbamylated protein antibodies in the diagnosis of rheumatoid arthritis

目的采用Meta分析方法综合评价抗氨基甲酰化蛋白(CarP)抗体诊断类风湿关节炎(RA)的效果。方法通过检索Pubmed、万方、维普、CNKI 4个数据库,获得有价值的CarP抗体诊断RA的文献,直接或间接提取真阳性数(TP)、假阳性数(NP)、假阴性数(FN)、真阴性数(TN);采用Revman 5.3、Meta-Disc 1.4、Stata 14.0软件进行诊断试验Meta分析,采用加权法、非加权法及稳健法分别拟合筛查方法的受试者工作特征(ROC)曲线。采用QUADAS-2的方法学质量评价体系进行总结。结果血清CarP抗体诊断RA灵敏度为0.43、特异度为0.92,阳性似然比为6.07,阴性似然比为0.65,AUC为9.43。结论CarP抗体对RA具有中等的诊断价值,特异度较高,但对RA诊断的灵敏度较低。

Objective Meta-analysis of diagnostic test was used to evaluate the effect of anti-carbamoylated protein antibody(anti-Carp antibody)in the diagnosis of rheumatoid arthritis(RA).Methods By searching Pubmed,Wanfang,Weipu,CNKI databases,valuable anti-Carp antibody diagnostic RA literatures were obtained.True positive number(TP),false positive number(NP),false negative number(FN),true negative number(TN)were extracted directly or indirectly,and Revman 5.3,Meta-Disc 1.4,Stata 14.0 were used for Meta-analysis of diagnostic test,and weighted,non-weighted and soundness methods were used to fit the receiver operating characteristic curve(ROC curve)of screening method.Methodological quality evaluation of QUADAS-2 was summarized.Results The sensitivity of serum CarP antibody to RA was 0.43,the specificity was 0.92,the positive likelihood ratio was 6.07,the negative likelihood ratio was 0.65,and the AUC value of ROC was 9.43.Conclusion CarP antibody has medium diagnostic value for RA,high specificity,low sensitivity for RA diagnosis.