抗聚絲蛋白抗體診斷類風濕性關節炎的Meta分析_《中國循證醫學雜志》

作者：

汪澤皓 ^1,2 , 移康 ^1,2 , 楊銳 ³ , 田金徽 ¹ ,  楊克虎 ¹

1. 蘭州大學循證醫學中心，蘭州大學基礎醫學院（蘭州 730000）；2. 蘭州大學第一醫院（蘭州 730000）；3. 甘肅省第二人民醫院（蘭州 730000）;

關鍵詞：

抗聚絲蛋白抗體類風濕性關節炎診斷性試驗 Meta分析

DOI：

10.7507/1672-2531.20120168

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目的　評價抗聚絲蛋白抗體（AFA）對類風濕性關節炎（RA）診斷的準確性。
方法　計算機檢索PubMed（1966～2010.8）、Cochrane Library（2010年第8期）、EMbase（1974～2010.8）、中國生物醫學文獻數據庫（1978～2010.8）、CNKI（1994～2010.8）、VIP（1989～2010.8）和中華醫學會數字化期刊庫（1997～2010.8）等，并追索納入研究的參考文獻，查找AFA與修訂的RA分類標準（ACR）比較診斷類風濕性關節炎的診斷性試驗，依據QUADAS質量評價標準評價納入研究的質量，采用Meta-Disc 1.4軟件進行Meta分析。
結果　共納入18篇文獻，6 971例受試者。Meta分析結果顯示：與ACR相比，AFA診斷RA的合并敏感度、特異度、陽性似然比、陰性似然比、診斷OR值和SROC分別為0.52（0.50，0.54）、0.93（0.92，0.94）、7.11（5.35，9.45）、0.53（0.48，0.60）、13.82（9.93，19.24）和0.8347。
結論　應用免疫印跡和ELISA法檢測AFA時，其對RA的診斷效能高，有一定的臨床應用前景。

引用本文： 汪澤皓,移康,楊銳,田金徽,楊克虎. 抗聚絲蛋白抗體診斷類風濕性關節炎的Meta分析. 中國循證醫學雜志, 2012, 12(9): 1076-1082. doi: 10.7507/1672-2531.20120168 復制

1.	Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet, 2010, 76(9746): 1094-1108.
2.	Machold KP. Prevention and cure of rheumatoid arthritis: is it possible?. Best Pract Res Clin Rheumatol, 2010, 24(3): 353-361.
3.	Puszczewicz M, Iwaszkiewicz C. Role of anti-citrullinated protein antibodies in diagnosis and prognosis of rheumatoid arthritis. Arch Med Sci, 2011, 7(2): 189-194.
4.	Choi SW, Lim MK, Shin DH, et al. Diagnostic performances of anti-cyclic citrullinated peptides antibody and antifilaggrin antibody in Korean patients with rheumatoid arthritis. J Korean Med Sci, 2005, 20(3): 473-478.
5.	Simon M, Girbal E, Sebbag M, et al. The cytokeratin filament-aggregating protein filaggrin is the target of the so-called "antikeratin antibodies," autoantibodies specific for rheumatoid arthritis. J Clin Invest, 1993, 92(3): 1387-1393.
6.	Suzuki K, Sawada T, Murakami A, et al. High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol, 2003, 32(4): 197-204.
7.	Battaglia M, Bucher H, Egger M, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition, 2002.
8.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
9.	Vincent C, de Keyser F, Masson-Bessière C, et al. Anti-perinuclear factor compared with the so called "antikeratin" antibodies and antibodies to human epidermis filaggrin, in the diagnosis of arthritides. Ann Rheum Dis, 1999, 58(1): 42-48.
10.	Bas S, Perneger TV, Mikhnevitch E, et al. Association of rheumatoid factors and anti-filaggrin antibodies with severity of erosions in rheumatoid arthritis. Rheumatology (Oxford), 2000, 39(10): 1082-1088.
11.	Choi SW, Lim MK, Shin DH, et al. Diagnostic performances of anti-cyclic citrullinated peptides antibody and antifilaggrin antibody in Korean patients with rheumatoid arthritis. J Korean Med Sci, 2005, 20(3): 473-478.
12.	Dubucquoi S, Solau-Gervais E, Lefranc D, et al. Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis, 2004, 63(4): 415-419.
13.	Suzuki K, Sawada T, Murakami A, et al. High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol, 2003, 32(4): 197-204.
14.	Nogueira L, Sebbag M, Vincent C, et al. Performance of two ELISAs for antifilaggrin autoantibodies, using either affinity purified or deiminated recombinant human filaggrin, in the diagnosis of rheumatoid arthritis. Ann Rheum Dis, 2001, 60(9): 882-887.
15.	Goldbach-Mansky R, Lee J, McCoy A, et al. Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset. Arthritis Res, 2000, 2(3): 236-243.
16.	Aho K, Palosuo T, Lukka M, et al. Antifilaggrin antibodies in recent-onset arthritis. Scand J Rheumatol, 1999, 28(2): 113-116.
17.	Ferraro-Peyret C, Tebib J, Desbos A, et al. Improvement in diagnosis of rheumatoid arthritis using dual indirect immunofluorescence and immunoblotting assays for antifilaggrin autoantibodies: a retrospective 3 year study. J Rheumatol, 2002, 29(2): 276-281.
18.	張莉蕓, 李小峰, 胡學芳, 等. 間接免疫熒光法和免疫印跡法聯合檢測抗聚角蛋白微絲蛋白抗體對類風濕關節炎的診斷價值. 中華風濕病學雜志, 2004, 8(6): 338-341.
19.	艾脈興, 冷曉梅, 曾小峰. 檢測抗聚絲蛋白抗體在類風濕關節炎診斷中的意義. 基礎醫學與臨床, 2007, 27(9): 1052-1056.
20.	李守勇, 張婷蘭. 抗RA54抗體、抗CCP抗體、APF、AFA和RF聯合檢測診斷類風濕性關節炎的臨床價值. 山東醫藥, 2005, 45(5): 25-25.
21.	劉斌, 曾慶馀. 抗纖聚蛋白抗體檢測及其在類風濕關節炎中的意義. 中華風濕病學雜志, 2002, 6(6): 429-432.
22.	張麗卿, 李小峰, 胡學芳, 等. 類風濕關節炎中抗纖聚蛋白抗體意義的探討. 中華風濕病學雜志, 2006, 10(4): 219-223.
23.	肖鎮, 白麗杰, 秦毅強. AFA、抗CCP抗體RF對類風濕關節炎診斷及病情評估的意義. 內蒙古醫學院學報, 2005, 27(4): 265-270,278.
24.	張蜀瀾, 李永哲, 佟大偉. 抗絲集蛋白抗體譜檢測在類風濕性關節炎診斷中的臨床意義. 中國醫學檢驗雜志, 2005, 6(3): 177-179.
25.	曹金, 李小峰, 胡學芳, 等. 抗聚角蛋白微絲蛋白抗體在早期類風濕關節炎中的意義. 中華風濕病學雜志, 2005, 9(5): 294-297.
26.	曾小峰, 張麗君. 抗聚角蛋白微絲蛋白抗體的檢測在類風濕關節炎診斷中的意義. 中華風濕病學雜志, 2002, 6(3): 157-160.
27.	劉斌. 纖聚蛋白與類風濕性關節炎, 現代診斷與治療, 2003, 14(5): 294-296.
28.	Forslind K, Vincent C, Serre G, et al. Antifilaggrin autoantibodies in early rheumatoid arthritis. Scand J Rheumatol, 2000, 29(5): 320-322.
29.	趙超, 王雪. 類風濕因子定量檢測在類風濕關節炎診治中的應用. 實用醫技雜志, 2005, 12(5): 1345.
30.	Dubucquoi S, Solau-Gervais E, Lefranc D, et al. Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic disease. Ann Rheum Dis, 2004, 63(4): 415-419.
31.	Tackmann R, Schuetz G, Hamm B, et al. Quality of the reporting of diagnostic accuracy studies: STARD (Standards for the Reporting of Diagnostic accuracy studies). Rofo, 2010, 182(8): 655-659.

1. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet, 2010, 76(9746): 1094-1108.
2. Machold KP. Prevention and cure of rheumatoid arthritis: is it possible?. Best Pract Res Clin Rheumatol, 2010, 24(3): 353-361.
3. Puszczewicz M, Iwaszkiewicz C. Role of anti-citrullinated protein antibodies in diagnosis and prognosis of rheumatoid arthritis. Arch Med Sci, 2011, 7(2): 189-194.
4. Choi SW, Lim MK, Shin DH, et al. Diagnostic performances of anti-cyclic citrullinated peptides antibody and antifilaggrin antibody in Korean patients with rheumatoid arthritis. J Korean Med Sci, 2005, 20(3): 473-478.
5. Simon M, Girbal E, Sebbag M, et al. The cytokeratin filament-aggregating protein filaggrin is the target of the so-called "antikeratin antibodies," autoantibodies specific for rheumatoid arthritis. J Clin Invest, 1993, 92(3): 1387-1393.
6. Suzuki K, Sawada T, Murakami A, et al. High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol, 2003, 32(4): 197-204.
7. Battaglia M, Bucher H, Egger M, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition, 2002.
8. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
9. Vincent C, de Keyser F, Masson-Bessière C, et al. Anti-perinuclear factor compared with the so called "antikeratin" antibodies and antibodies to human epidermis filaggrin, in the diagnosis of arthritides. Ann Rheum Dis, 1999, 58(1): 42-48.
10. Bas S, Perneger TV, Mikhnevitch E, et al. Association of rheumatoid factors and anti-filaggrin antibodies with severity of erosions in rheumatoid arthritis. Rheumatology (Oxford), 2000, 39(10): 1082-1088.
11. Choi SW, Lim MK, Shin DH, et al. Diagnostic performances of anti-cyclic citrullinated peptides antibody and antifilaggrin antibody in Korean patients with rheumatoid arthritis. J Korean Med Sci, 2005, 20(3): 473-478.
12. Dubucquoi S, Solau-Gervais E, Lefranc D, et al. Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis, 2004, 63(4): 415-419.
13. Suzuki K, Sawada T, Murakami A, et al. High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol, 2003, 32(4): 197-204.
14. Nogueira L, Sebbag M, Vincent C, et al. Performance of two ELISAs for antifilaggrin autoantibodies, using either affinity purified or deiminated recombinant human filaggrin, in the diagnosis of rheumatoid arthritis. Ann Rheum Dis, 2001, 60(9): 882-887.
15. Goldbach-Mansky R, Lee J, McCoy A, et al. Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset. Arthritis Res, 2000, 2(3): 236-243.
16. Aho K, Palosuo T, Lukka M, et al. Antifilaggrin antibodies in recent-onset arthritis. Scand J Rheumatol, 1999, 28(2): 113-116.
17. Ferraro-Peyret C, Tebib J, Desbos A, et al. Improvement in diagnosis of rheumatoid arthritis using dual indirect immunofluorescence and immunoblotting assays for antifilaggrin autoantibodies: a retrospective 3 year study. J Rheumatol, 2002, 29(2): 276-281.
18. 張莉蕓, 李小峰, 胡學芳, 等. 間接免疫熒光法和免疫印跡法聯合檢測抗聚角蛋白微絲蛋白抗體對類風濕關節炎的診斷價值. 中華風濕病學雜志, 2004, 8(6): 338-341.
19. 艾脈興, 冷曉梅, 曾小峰. 檢測抗聚絲蛋白抗體在類風濕關節炎診斷中的意義. 基礎醫學與臨床, 2007, 27(9): 1052-1056.
20. 李守勇, 張婷蘭. 抗RA54抗體、抗CCP抗體、APF、AFA和RF聯合檢測診斷類風濕性關節炎的臨床價值. 山東醫藥, 2005, 45(5): 25-25.
21. 劉斌, 曾慶馀. 抗纖聚蛋白抗體檢測及其在類風濕關節炎中的意義. 中華風濕病學雜志, 2002, 6(6): 429-432.
22. 張麗卿, 李小峰, 胡學芳, 等. 類風濕關節炎中抗纖聚蛋白抗體意義的探討. 中華風濕病學雜志, 2006, 10(4): 219-223.
23. 肖鎮, 白麗杰, 秦毅強. AFA、抗CCP抗體RF對類風濕關節炎診斷及病情評估的意義. 內蒙古醫學院學報, 2005, 27(4): 265-270,278.
24. 張蜀瀾, 李永哲, 佟大偉. 抗絲集蛋白抗體譜檢測在類風濕性關節炎診斷中的臨床意義. 中國醫學檢驗雜志, 2005, 6(3): 177-179.
25. 曹金, 李小峰, 胡學芳, 等. 抗聚角蛋白微絲蛋白抗體在早期類風濕關節炎中的意義. 中華風濕病學雜志, 2005, 9(5): 294-297.
26. 曾小峰, 張麗君. 抗聚角蛋白微絲蛋白抗體的檢測在類風濕關節炎診斷中的意義. 中華風濕病學雜志, 2002, 6(3): 157-160.
27. 劉斌. 纖聚蛋白與類風濕性關節炎, 現代診斷與治療, 2003, 14(5): 294-296.
28. Forslind K, Vincent C, Serre G, et al. Antifilaggrin autoantibodies in early rheumatoid arthritis. Scand J Rheumatol, 2000, 29(5): 320-322.
29. 趙超, 王雪. 類風濕因子定量檢測在類風濕關節炎診治中的應用. 實用醫技雜志, 2005, 12(5): 1345.
30. Dubucquoi S, Solau-Gervais E, Lefranc D, et al. Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic disease. Ann Rheum Dis, 2004, 63(4): 415-419.
31. Tackmann R, Schuetz G, Hamm B, et al. Quality of the reporting of diagnostic accuracy studies: STARD (Standards for the Reporting of Diagnostic accuracy studies). Rofo, 2010, 182(8): 655-659.

《中國循證醫學雜志》

抗聚絲蛋白抗體診斷類風濕性關節炎的Meta分析

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《中國循證醫學雜志》

抗聚絲蛋白抗體診斷類風濕性關節炎的Meta分析

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