目的 探讨血清软骨寡聚基质蛋白(Cartilage oligomeric matrix protein,COMP)对类风湿关节炎(Rheumatoid arthritis,RA)的诊断价值。方法 选取82例RA患者和34例健康对照人群,分为RA组和健康组。对类风湿关节炎患者,根据临床表现、实验室检查分为活动期组和缓解期组;根据放射学改变分为骨质破坏组和骨质未破坏组,并与抗环瓜氨酸抗体(抗CCP抗体)水平进行比较,评价COMP和抗CCP抗体在RA中的诊断作用,绘制ROC曲线,计算其各自的曲线下面积(AUC)、灵敏度、特异度。健康对照组检测指标同RA患者。结果 RA患者血清COMP水平显著高于健康对照人群(P<0.05),活动期组COMP水平显著高于缓解期组(P<0.05),骨质破坏组COMP水平高于骨质未破坏组(P=0.0156);当COMP和抗CCP抗体各自以21.51 ng/ml和34.76 RU/ml为最佳截断值来区分RA患者和健康人群时,COMP的AUC(0.864)、灵敏度(0.817)、特异度(0.882)均高于抗CCP抗体的AUC(0.764)、灵敏度(0.610)、特异度(0.824)。结论 COMP 作为软骨破坏的一种生物标记物,可以用来鉴别RA患者和健康人。
Abstract
Objective To analyze the role of serum cartilage oligomeric matrix protein (COMP) levels in differential diagnosis of rheumatoid arthritis (RA).Methods Eighty-two patients with RA and another thirty-four healthy control subjects were enrolled and divided into RA patients and healthy controls.According to clinical manifestations and results of laboratory examination, the patients were divided into active patients and patients in remission.According to the radiological changes,these patients were again divided into patients with joint bony damages and those without joint bony damage.The diagnostic ability of COMP for RA was evaluated by comparing it with anti-cyclic citrullinated peptide (anti-CCP) antibody levels.Receiver operating characteristic(ROC) curves were plotted before the areas under the ROC curves(AUC),while sensitivity and specificity were calculated.Results The serum COMP level was significantly higher in patients with RA than in control subjects(P<0.05), in active patients than in those in remission(P<0.05),and in patients with joint bony damages than in those without joint bony damage(P<0.05).When COMP and anti-CCP were used to distinguish between RA patients and healthy controls at the optimal cut-off value of 21.51 ng/ml and 34.76 RU/ml respectively, COMP’s AUC was (0.864), sensitivity (0.817) and specificity was (0.882), higher than those of anti CCP’s AUC (0.764), sensitivity (0.610) and specificity (0.824).Conclusions The serum COMP level can be used as a biological marker for cartilage destruction and for differentiating between patients with RA and healthy individuals.
关键词
血清软骨寡聚基质蛋白 /
类风湿关节炎 /
抗环瓜氨酸抗体
Key words
cartilage oligomeric matrix protein /
rheumatoid arthritis /
anti-cyclic citrullinated peptide antibody
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