抗聚丝蛋白抗体诊断类风湿性关节炎的Meta分析_《中国循证医学杂志》

作者：

汪泽皓 ^1,2 , 移康 ^1,2 , 杨锐 ³ , 田金徽 ¹ ,  杨克虎 ¹

1. 兰州大学循证医学中心，兰州大学基础医学院（兰州 730000）；2. 兰州大学第一医院（兰州 730000）；3. 甘肃省第二人民医院（兰州 730000）;

关键词：

抗聚丝蛋白抗体类风湿性关节炎诊断性试验 Meta分析

DOI：

10.7507/1672-2531.20120168

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　评价抗聚丝蛋白抗体（AFA）对类风湿性关节炎（RA）诊断的准确性。
方法　计算机检索PubMed（1966～2010.8）、Cochrane Library（2010年第8期）、EMbase（1974～2010.8）、中国生物医学文献数据库（1978～2010.8）、CNKI（1994～2010.8）、VIP（1989～2010.8）和中华医学会数字化期刊库（1997～2010.8）等，并追索纳入研究的参考文献，查找AFA与修订的RA分类标准（ACR）比较诊断类风湿性关节炎的诊断性试验，依据QUADAS质量评价标准评价纳入研究的质量，采用Meta-Disc 1.4软件进行Meta分析。
结果　共纳入18篇文献，6 971例受试者。Meta分析结果显示：与ACR相比，AFA诊断RA的合并敏感度、特异度、阳性似然比、阴性似然比、诊断OR值和SROC分别为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。
结论　应用免疫印迹和ELISA法检测AFA时，其对RA的诊断效能高，有一定的临床应用前景。

引用本文： 汪泽皓,移康,杨锐,田金徽,杨克虎. 抗聚丝蛋白抗体诊断类风湿性关节炎的Meta分析. 中国循证医学杂志, 2012, 12(9): 1076-1082. doi: 10.7507/1672-2531.20120168 复制

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.	张莉芸, 李小峰, 胡学芳, 等. 间接免疫荧光法和免疫印迹法联合检测抗聚角蛋白微丝蛋白抗体对类风湿关节炎的诊断价值. 中华风湿病学杂志, 2004, 8(6): 338-341.
19.	艾脉兴, 冷晓梅, 曾小峰. 检测抗聚丝蛋白抗体在类风湿关节炎诊断中的意义. 基础医学与临床, 2007, 27(9): 1052-1056.
20.	李守勇, 张婷兰. 抗RA54抗体、抗CCP抗体、APF、AFA和RF联合检测诊断类风湿性关节炎的临床价值. 山东医药, 2005, 45(5): 25-25.
21.	刘斌, 曾庆馀. 抗纤聚蛋白抗体检测及其在类风湿关节炎中的意义. 中华风湿病学杂志, 2002, 6(6): 429-432.
22.	张丽卿, 李小峰, 胡学芳, 等. 类风湿关节炎中抗纤聚蛋白抗体意义的探讨. 中华风湿病学杂志, 2006, 10(4): 219-223.
23.	肖镇, 白丽杰, 秦毅强. AFA、抗CCP抗体RF对类风湿关节炎诊断及病情评估的意义. 内蒙古医学院学报, 2005, 27(4): 265-270,278.
24.	张蜀澜, 李永哲, 佟大伟. 抗丝集蛋白抗体谱检测在类风湿性关节炎诊断中的临床意义. 中国医学检验杂志, 2005, 6(3): 177-179.
25.	曹金, 李小峰, 胡学芳, 等. 抗聚角蛋白微丝蛋白抗体在早期类风湿关节炎中的意义. 中华风湿病学杂志, 2005, 9(5): 294-297.
26.	曾小峰, 张丽君. 抗聚角蛋白微丝蛋白抗体的检测在类风湿关节炎诊断中的意义. 中华风湿病学杂志, 2002, 6(3): 157-160.
27.	刘斌. 纤聚蛋白与类风湿性关节炎, 现代诊断与治疗, 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.	赵超, 王雪. 类风湿因子定量检测在类风湿关节炎诊治中的应用. 实用医技杂志, 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. 张莉芸, 李小峰, 胡学芳, 等. 间接免疫荧光法和免疫印迹法联合检测抗聚角蛋白微丝蛋白抗体对类风湿关节炎的诊断价值. 中华风湿病学杂志, 2004, 8(6): 338-341.
19. 艾脉兴, 冷晓梅, 曾小峰. 检测抗聚丝蛋白抗体在类风湿关节炎诊断中的意义. 基础医学与临床, 2007, 27(9): 1052-1056.
20. 李守勇, 张婷兰. 抗RA54抗体、抗CCP抗体、APF、AFA和RF联合检测诊断类风湿性关节炎的临床价值. 山东医药, 2005, 45(5): 25-25.
21. 刘斌, 曾庆馀. 抗纤聚蛋白抗体检测及其在类风湿关节炎中的意义. 中华风湿病学杂志, 2002, 6(6): 429-432.
22. 张丽卿, 李小峰, 胡学芳, 等. 类风湿关节炎中抗纤聚蛋白抗体意义的探讨. 中华风湿病学杂志, 2006, 10(4): 219-223.
23. 肖镇, 白丽杰, 秦毅强. AFA、抗CCP抗体RF对类风湿关节炎诊断及病情评估的意义. 内蒙古医学院学报, 2005, 27(4): 265-270,278.
24. 张蜀澜, 李永哲, 佟大伟. 抗丝集蛋白抗体谱检测在类风湿性关节炎诊断中的临床意义. 中国医学检验杂志, 2005, 6(3): 177-179.
25. 曹金, 李小峰, 胡学芳, 等. 抗聚角蛋白微丝蛋白抗体在早期类风湿关节炎中的意义. 中华风湿病学杂志, 2005, 9(5): 294-297.
26. 曾小峰, 张丽君. 抗聚角蛋白微丝蛋白抗体的检测在类风湿关节炎诊断中的意义. 中华风湿病学杂志, 2002, 6(3): 157-160.
27. 刘斌. 纤聚蛋白与类风湿性关节炎, 现代诊断与治疗, 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. 赵超, 王雪. 类风湿因子定量检测在类风湿关节炎诊治中的应用. 实用医技杂志, 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.

《中国循证医学杂志》

抗聚丝蛋白抗体诊断类风湿性关节炎的Meta分析

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《中国循证医学杂志》

抗聚丝蛋白抗体诊断类风湿性关节炎的Meta分析

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