血清生物标志物Anti-MCV,SAA和Anti-CCP与类风湿关节炎疾病的相关性研究

A Correlation Study of Serum Biomarkers Anti-MCV,SAA,Anti-CCP and Rheumatoid Arthritis

目的探讨Anti-MCV、SAA及Anti-CCP 3项生物标志物联合检测类风湿关节炎的研究价值。方法选取2020年5月至2020年11月来本院就诊的50例类风湿关节炎(RA)患者;50例自身免疫病患者,如系统性红斑狼疮(SLE)患者、干燥综合征(SS)患者、骨关节炎(OA)患者等;50例健康对照(NC)者,分别检测Anti-MCV、SAA及Anti-CCP这3项生物标志物,并分析基线资料,灵敏度、特异性,ROC曲线及曲线下面积,Spearman相关性及二元Logistics回归分析。结果Anti-MCV、SAA及Anti-CCP在RA组中的表达水平显著高于非RA组、NC组,差异有统计学意义(P<0.001)。Anti-MCV、SAA、Anti-CCP及3项联合检测诊断RA的临床效能评价中,3项联检灵敏度为94.00%,优于单项检测;特异性Anti-CCP为94.00%,优于其他检测;Anti-CCP和二联检(Anti-MCV+Anti-CCP)的诊断效率均为89.33%,优于其他检测;Anti-CCP的平衡错误率(balanced error rate,BER)为11.33%,低于其余检测;二联检(Anti-MCV+Anti-CCP)约登指数为0.79,优于其余检测。3项生物标志物及3项联合检测的曲线下面积分别为0.898、0.751、0.866和0.932。Logistics回归分析结果显示,3项联检的拟合度为94.00%,优于其他单项检测。相关性分析显示,Anti-MCV与SAA的相关系数为0.40,P<0.05且有相关性;Anti-MCV与Anti-CCP的相关系数为0.69,P<0.05具有强相关性;SAA与Anti-CCP相关系数为0.32,P<0.05相关性较弱。结论Anti-MCV、SAA及Anti-CCP这3项生物标志物在类风湿关节炎的联合检测中具有重要的临床价值,在其他自身免疫病的鉴别诊断中发挥着重要的作用。

Objective To study the clinical value of combining three biomarkers:Anti-MCV,SAA and Anti-CCP,for the detection of rheumatoid arthritis.Methods From May,2020 to November,2020,50 patients with rheumatoid arthritis(RA),50 patients with other autoimmune diseases,such as Systemic Lupus Erythematosus(SLE),Sjogren Syndrome(SS),and Osteoarthritis(OA),and 50 healthy controls(NC)were selected and tested for Anti-MCV,SAA and Anti-CCP.The results were analyzed at baseline level,as well as sensitivity,specificity,ROC curve and area under the curve.Spearman correlation and binary logistic regression analysis were also conducted.Results Expression levels of Anti-MCV,SAA and Anti-CCP in the RA group were significantly higher than those in the non-RA and NC groups(P<0.001).For the evaluation of the clinical efficacy of Anti-MCV,SAA,Anti-CCP individually and three-combined tests for the diagnosis of RA,the sensitivity of the three-combined test was 94.00%,which was better than that of the single-marker test,while the specificity of Anti-CCP was 94.00%,which was better than that of other tests.The diagnostic efficiency of Anti-CCP and the duplex test(Anti-MCV+Anti-CCP)was 89.33%,which was better than other tests.Balanced error rate(BER)of Anti-CCP was 11.33%,which was lower than other tests.The duplex test(Anti-MCV+Anti-CCP)was 11.33%,which was lower than other tests.Yordon index of Anti-MCV+Anti-CCP was 0.79,which was better than other tests.The area under the curve for the three individual biomarkers and the three-combined tests were 0.898,0.751,0.866 and 0.932,respectively.Logistic regression analysis showed that the fit of the three combined tests was 94.00%,which was better than single-marker tests.Correlation analysis showed as following:the correlation coefficient of Anti-MCV and SAA was 0.40(P<0.05);the correlation coefficient of Anti-MCV and Anti-CCP was 0.69(P<0.05);the correlation coefficient of SAA and Anti-CCP was 0.32(P<0.05).Conclusion Anti-MCV,SAA and Anti-CCP have significant clinical values when used as combined detection of rheumatoid arthritis and can facilitate the differential diagnosis of other autoimmune diseases.