Background: The goal of our study was to evaluate the diagnostic performance of the anti-cyclic citrullinated peptide 2 (anti-CCP2) assay in patients with autoimmune and inflammatory disorders.Methods: We tested the specificity and sensitivity of anti-CCP2 antibodies measured by ELISA in 787 patients with rheumatoid arthritis (RA), 1024 patients with other autoimmune/inflammatory rheumatic disease and 401 subjects without autoimmune rheumatic disease. The optimal cut-off value was defined as the value with the highest diagnostic accuracy (receiver operating characteristic curve analysis). Interval-specific likelihood ratios (LRs) were calculated for each range bounded by defined anti-CCP2 values.Results: To distinguish between patients with RA and controls, the cut-off value with the highest diagnostic accuracy for anti-CCP2 was 2.8 U/mL. Comparing the optimal cutoff value for anti-CCP2 to that recommended by the manufacturer (5.0 U/mL), an increase in prevalence between the proportions of test-positive patients was found for RA, undifferentiated connective tissue disease and undifferentiated arthritis. Evaluating interval-specific LRs for the selected ranges bound by two anti-CCP2 values, in RA and diseased controls, the LRs were 0.40 for values <5.0 U/mL, 6.66 for 5.0-15.0 U/mL, 27.01 for 15.1-30.0 U/mL and 28.89 for) 30.0 U/mL.Conclusions: The cut-off value of 2.8 U/mL for anti-CCP2 has the highest diagnostic accuracy. A value of anti-CCP2) 15 U/mL is associated with an increase in the likelihood of RA disease. Clin Chem Lab Med 2010;48:829-34.

Pietrapertosa, D., Tolusso, B., Gremese, E., Papalia, M. C., Bosello, S. L., Peluso, G., Petricca, L., Michelutti, A., Faustini, F., Fedele, A. L., Ferraccioli, G., Diagnostic performance of anti-citrullinated peptide antibodies for the diagnosis of rheumatoid arthritis: the relevance of likelihood ratios, <<CLINICAL CHEMISTRY AND LABORATORY MEDICINE>>, 2010; 48 (6): 829-834. [doi:10.1515/CCLM.2010.152] [https://hdl.handle.net/10807/237895]

Diagnostic performance of anti-citrullinated peptide antibodies for the diagnosis of rheumatoid arthritis: the relevance of likelihood ratios

Tolusso, Barbara;Gremese, Elisa;Bosello, Silvia Laura;Peluso, Giusy;Petricca, Luca;Fedele, Anna Laura;Ferraccioli, Gianfranco
2010

Abstract

Background: The goal of our study was to evaluate the diagnostic performance of the anti-cyclic citrullinated peptide 2 (anti-CCP2) assay in patients with autoimmune and inflammatory disorders.Methods: We tested the specificity and sensitivity of anti-CCP2 antibodies measured by ELISA in 787 patients with rheumatoid arthritis (RA), 1024 patients with other autoimmune/inflammatory rheumatic disease and 401 subjects without autoimmune rheumatic disease. The optimal cut-off value was defined as the value with the highest diagnostic accuracy (receiver operating characteristic curve analysis). Interval-specific likelihood ratios (LRs) were calculated for each range bounded by defined anti-CCP2 values.Results: To distinguish between patients with RA and controls, the cut-off value with the highest diagnostic accuracy for anti-CCP2 was 2.8 U/mL. Comparing the optimal cutoff value for anti-CCP2 to that recommended by the manufacturer (5.0 U/mL), an increase in prevalence between the proportions of test-positive patients was found for RA, undifferentiated connective tissue disease and undifferentiated arthritis. Evaluating interval-specific LRs for the selected ranges bound by two anti-CCP2 values, in RA and diseased controls, the LRs were 0.40 for values <5.0 U/mL, 6.66 for 5.0-15.0 U/mL, 27.01 for 15.1-30.0 U/mL and 28.89 for) 30.0 U/mL.Conclusions: The cut-off value of 2.8 U/mL for anti-CCP2 has the highest diagnostic accuracy. A value of anti-CCP2) 15 U/mL is associated with an increase in the likelihood of RA disease. Clin Chem Lab Med 2010;48:829-34.
2010
Inglese
Pietrapertosa, D., Tolusso, B., Gremese, E., Papalia, M. C., Bosello, S. L., Peluso, G., Petricca, L., Michelutti, A., Faustini, F., Fedele, A. L., Ferraccioli, G., Diagnostic performance of anti-citrullinated peptide antibodies for the diagnosis of rheumatoid arthritis: the relevance of likelihood ratios, <<CLINICAL CHEMISTRY AND LABORATORY MEDICINE>>, 2010; 48 (6): 829-834. [doi:10.1515/CCLM.2010.152] [https://hdl.handle.net/10807/237895]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/237895
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