第一代與第二代抗環瓜氨酸抗體（CCP1 and CCP2）對類風濕性關節炎的敏感度及特異性之比較

A comparison of the diagnostic sensitivity.and specificity of two anti-cyclic citrullinated peptides (CCP1 and CCP2) tests for rheumatoid arthritis

前言：抗環瓜氨酸抗體anti-citrullinated peptide（CCP）在診斷風濕性關節炎被認為是一種有用的檢驗工具。這時，我們將40位類風濕性關節炎病患使用抗環瓜氨酸抗體來檢查，分別比較以ELISA為基礎的anti-CCP1及EliA為基礎的anti-CCP2的敏感度及特異性。材料與方法：79名關節病變的患者同時以Anti-CCP1和anti-CCP2抗體做測試，並區別類風濕性關節炎與非類風濕性關節炎的敏感度、特異性、陽性預測值和陰性預測值。結果：Anti-CCP1和anti-CCP2在診斷類風濕性關節炎有極相似的特異性。然而，anti-CCP2與anti-CCP1之間並無明顯的相關性。結論：Anti-CCP比傳統的IgM-RF更真敏感度及特異性。但anti-CCP2在類風濕性關節炎診斷上並沒有比anti-CCP1來得好。

Objective. The detection of anti-cyclic citrullinated peptide (CCP) autoantibodies has been considered a useful tool to identify rheumatoid arthritis (RA) patients. Here, we examined the sensitivity and specificity of two detection methods, namely the ELISA-based (anti-CCP1) and the EliA- based (antiCCP2) for anti-CCP in 40 RA patients. Methods. Anti-CCP1 and anti-CCP2 antibody tests were performed on 79 patients with arthropathy. The sensitivity, specificity, positive predictive value, and negative predictive value for-discriminating between rheumatoid arthritis (RA) and non-RA were calculated for both tests. Results. Both anti-CCP1 and anti-CCP2 shared very similar specificities (97.4%) toward diagnosing RA. However, there was no significant associations between the titer of allti-CCP1 and anti-CCP2. Conclusion. Anti-CCP test was more sensitive and specific than traditional IgM-RF. However, anti-CCP2 was not significantly better than anti-CCP1 in the diagnosis of RA.