Serum connective tissue growth factor is a highly discriminatory biomarker for the diagnosis of rheumatoid arthritis

被引:23
|
作者
Yang, Xinyu [1 ]
Lin, Ke [2 ]
Ni, Shanmin [2 ]
Wang, Jianmin [3 ]
Tian, Qingqing [2 ]
Chen, Huaijun [2 ]
Brown, Matthew A. [4 ,5 ]
Zheng, Kaidi [2 ]
Zhai, Weitao [6 ]
Sun, Li [7 ]
Jin, Shengwei [8 ]
Wang, Jianguang [2 ]
机构
[1] Wenzhou Med Univ, Sch Pharmaceut Sci, Dept Med Chem, Wenzhou, Peoples R China
[2] Wenzhou Med Univ, Sch Basic Med Sci, Dept Biochem, Wenzhou 325035, Peoples R China
[3] Jiamusi Cent Hosp, Dept Rheumatol, Jiamusi, Peoples R China
[4] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Translat Res Inst, Princess Alexandra Hosp, Brisbane, Qld, Australia
[5] Wenzhou Med Univ, Ctr Precis Med, Affiliated Hosp 1, Wenzhou, Peoples R China
[6] Shanghai Guanghua Special Hosp Rheumatoid Arthrit, Dept Orthopaed Surg, Shanghai, Peoples R China
[7] Wenzhou Med Univ, Dept Immunol & Rheumatol, Affiliated Hosp 1, Wenzhou 325035, Peoples R China
[8] Wenzhou Med Univ, Dept Anesthesia & Crit Care, Affiliated Hosp 2, Wenzhou 325035, Peoples R China
基金
中国国家自然科学基金;
关键词
Rheumatoid arthritis; CTGF; ACPA; Rheumatoid factor; Biomarker; CITRULLINATED PEPTIDE ANTIBODIES; CLASSIFICATION CRITERIA; COMBINED TESTS; ACCURACY; METAANALYSIS; DISORDERS;
D O I
10.1186/s13075-017-1463-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Our previous proteomic study indicated that connective tissue growth factor (CTGF) may be a potential biomarker for rheumatoid arthritis (RA) diagnosis. The aim was to assess the performance of CTGF as a biomarker of RA. Method: Serum and synovial fluid CTGF was detected using a direct high sensitivity sandwich ELISA kit. Serum CTGF levels were tested for discriminatory capacity and optimal assay cutoffs determined in a training cohort of 98 cases of RA with 103 healthy controls. The assay performance was then validated in a further cohort of 572 patients (with RA (n = 217), ankylosing spondylitis (n = 92), gout (n = 74), osteoarthritis (n = 52), systemic lupus erythematosus (n = 72), or primary Sjgren's syndrome (pSS) (n = 65)). Results: Significant elevation of synovial fluid CTGF concentration was found in RA patients, demonstrating excellent diagnostic ability to predict RA (area under the curve (AUC) = 0.97). Similar results were found in serum CTGF detection. At the optimal cutoff value 88.66 pg/mL, the sensitivity, specificity, and the AUC was 0.86, 0.92, and 0.92, respectively, in the training cohort. Similar performance was observed in the validation cohort, with sensitivity, specificity, positive likelihood, and negative likelihood of 0.82, 0.91, 5.74, and 0.12, respectively. Stronger discriminatory capacity was seen with the combination of CTGF and anti-citrullinated protein antibody (ACPA) (AUC = 0.96) than with either ACPA or rheumatoid factor (RF) alone (AUC = 0.80 or 0.79, respectively). The discriminatory performance of serum CTGF was consistent across all inflammatory conditions tested (AUC > 0.92 in all cases), with the sole exception of pSS. Serum CTGF did not vary with symptom duration or disease activity. Conclusions: Serum CTGF is a promising diagnostic biomarker for RA, with performance in the current study better than either ACPA or RF.
引用
收藏
页数:9
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