Korean J Lab Med.  2003 Dec;23(6):405-410.

Diagnostic Role of the Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis

• Kim KH

Abstract

BACKGROUND
Rheumatoid arthritis (RA) is the most common systemic autoimmune disease; but there are no useful, specific and practicable tests for this diagnosis. We evaluated the diagnostic performance of anti-cyclic citrullinated peptide antibodies (anti-CCP) using ELISA for the diagnosis of RA. METHODS: Anti-CCP (EURO-DIAGNOSTICA, MALMo, Sweden) was determined in serum samples from 114 patients with RA and 202 controls (31 SLE, 40 osteoarthritis, 75 other diseases, and 56 healthy subjects). The Rheumatoid factor (RF) by turbidimetry was also assayed and results were compared to anti-CCP for sensitivity and specificity by the receiver-operating characteristic (ROC) curve. RESULTS: At each optimum cut-off value, the sensitivities of anti-CCP and RF were 68.4% and 66.7% and the specificities were 96% and 84.6%, respectively. RA patients with anti-CCP had a mean antibody concentration of 559.6+/-752.0 U/mL (range, 24 - 4717). Thirteen of 38 (34.2%) sera from RF negative RA patients were positive for anti-CCP. On each ROC curve, the area under the curve was 0.872 (confidence interval, 0.827 - 0.917) for anti-CCP and 0.794 (CI, 0.737 - 0.851) for RF, which showed no statistically significant difference. CONCLUSIONS: We considered that anti-CCP could be a useful test with excellent diagnostic performance for the diagnosis of RA.

Keyword

arthritis; Anti-cyclic citrullinated peptide antibodies (anti-CCP); Rheumatoid factor; Sensitivity

MeSH Terms

Antibodies*
Arthritis
Arthritis, Rheumatoid*
Autoimmune Diseases
Diagnosis
Enzyme-Linked Immunosorbent Assay
Humans
Nephelometry and Turbidimetry
Osteoarthritis
Rheumatoid Factor
ROC Curve
Sensitivity and Specificity
Antibodies
Rheumatoid Factor