| ObjectiveRheumatoid arthritis (RA) is a common chronic inflammatory disorder of unknown cause that primarily affects the small joints of hands and feet, and leads to cartilage destruction and ankylosis. RA is a clinical diagnosis based on clinical presentation and symptoms, but a definitive diagnosis is often difficult only by clinical criteria. RA is associated with multiple autoantibodies. The autoantibodies include rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, glucose-6-phosphate isomerase(GPI) and so on. In addition, clinical experimental evidences suggest that rheumatoid serum and synovial tissue high produce interleukin-17(IL-17), which causes cartilage and bone degradation. This indicates that IL-17is also a powerful diagnostic and therapeutic index for RA. Whether combined detection of RF, anti-CCP antibody, GPI and IL-17can improve the diagnosis for RA? There is few research about it. This article is to investigate the diagnostic value for the patients with RA by detecting RF, anti-CCP antibody, GPI and IL-17jointly, and obtain a new clue to enriching RA diagnosis.MethodsAll subjects were collected from Jinan Central Hospital affiliated to Shandong University. Clinical history and indicators were gathered from the inpatient. RF were examined with rate scatter nephelometry in the serum of40patients with rheumatoid arthritis (RA group),40other autoimmune diseases (non-RA group), and20healthy subjects (normal control group). Anti-CCP antibody, GPI, IL-17levels were detected by enzyme linked immunosorbent assays (ELISAs) in the serum of RA group, non-RA group and normal control group.Results1. Among RA group,80.0%showed positive of RF and72.5%showed positive of anti-CCP antibody and57.5%showed positive of GPI antigen respectively. Among non-RA group,40.0%showed positive of RF and12.5%showed positive of anti-CCP antibody and5.0%showed positive of GPI antigen. Among normal control group,10.0%showed positive of RF and10.0%showed positive of anti-CCP antibody and0.0%showed positive of GPI antigen. The positive rate of serum RF, anti-CCP antibody and GPI in patients with RA group were significantly higher than those in non-RA group and normal control group.2. The sensitivity and specificity of serum RF for RA were80.0%and70.0%. The sensitivity and specificity of serum anti-CCP antibody for RA were72.5%and88.3%. The sensitivity and specificity of serum GPI for RA were57.5%and96.7%. Comparing with RF, the specificity of anti-CCP antibody or GPI increased significantly (P＜0.05). Comparing with RF, the sensitivity of anti-CCP antibody had no statistical significance (P>0.05) and the sensitivity of GPI had statistical significance(P<0.05).3. The specificity of both RF and anti-CCP antibody group, RF and GPI group, anti-CCP antibody and GPI group were91.7%,98.3%and98.3%respectively when both index were positive simultaneous. And the sensitivity of the three groups were90.0%,82.5%and82.5%respectively. The RF and anti-CCP antibody group had the highest sensitivity compared with other groups. The RF and GPI group or anti-CCP antibody and GPI group had the highest specificity simultaneous.4. Comparing with RF, anti-CCP antibody or GPI, the sensitivity (92.5%) increased significantly and the specificity (98.33%) increased significantly, when RF, anti-CCP antibody and GPI were detected simultaneously.5. The level of serum IL-17in patients with RA group were (53.8±3.7) pg/ml, (32.2±5.6) pg/ml in patients with non-RA group and (21.4±6.6) pg/ml in normal control group. The level of serum IL-17in RA group and non-RA group were significantly higher than those in normal control group (P＜0.05). The level of serum IL-17in RA group were higher than those in non-RA group, however there was no statistical significance between them (P>0.05).6. The level of serum IL-17had a positive correlations with RF in RA(P<0.05), whereas no correlations were shown between anti-CCP antibody and GPI (P>0.05)Conclusions1. The positive rate of serum RF, anti-CCP antibody and GPI in patients with RA group were increased significantly, and the specificity of anti-CCP antibody and GPI were higher than RF.2. Both sensitivity and specificity of detection were improved when the combined detection of RF, anti-CCP antibody and GPI was used in the patients with RA.3. The level of serum IL-17in RA was increased obviously, and they had a positive correlation with RF, whereas no correlation was shown between anti-CCP antibody and GPI.4. The diagnosis of RA were improved when the combined detection of RF, anti-CCP antibody, GPI and IL-17were used. |
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