A Systematic Review of Serum Biomarkers Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor as Tests for Rheumatoid Arthritis

[摘要] This systematic review assesses the current status of anti-cycliccitrullinated peptide (anti-CCP) and rheumatoid factor (RF) tests inthe diagnosis and prognosis of rheumatoid arthritis (RA).We reviewedpublications on tests and biomarkers for early diagnosis of RA fromEnglish-language MEDLINE-indexed journals and non-MEDLINE-indexedsources.85 publications were identified and reviewed, including 68studies from MEDLINE and 17 non-MEDLINE sources.Anti-CCP2 assaysprovide improved sensitivity over anti-CCP assays and RF, butanti-CCP2 and RF assays in combination demonstrate a positivepredictive value (PPV) nearing 100%, greater than the PPV of either ofthe tests alone. The combination also appears to be able todistinguish between patients whose disease course is expected to bemore severe and both tests are incorporated in the 2010 ACR RheumatoidArthritis Classification Criteria.While the clinical value ofanti-CCP tests has been established, differences in cut-off values,sensitivities and specificities exist between first-, second- andthird-generation tests and harmonization efforts are under way. Anti-CCP and RF are clinically valuable biomarkers for the diagnosisand prognosis of RA patients.The combination of the two biomarkersin conjunction with other clinical measures is an important tool forthe diagnosis and management of RA patients.

[学科分类] 内科医学