{"title":"类风湿关节炎瓜氨酸肽（RACP）系统在2632例类风湿关节炎诊断中的价值","authors":"Kun Yang, Sixing Li, Leting Zheng, Fei Dong, Jing Wen, Zhendong He, Jiale Wen, Fang Qin","doi":"10.1111/1756-185x.70393","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives and Aim</h3>\n \n <p>This study aimed to evaluate the diagnostic accuracy and prognostic value of the Rheumatoid Arthritis Citrullinated Peptides (RACP) assay in a real-world cohort, assessing its performance both independently and in combination with established biomarkers such as anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), and anti-keratin antibodies (AKA).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A single-center retrospective analysis included 2632 patients who underwent serological testing between September 2022 and September 2023. Of these, 644 patients met ACR/EULAR classification criteria for rheumatoid arthritis (RA), while 1988 patients served as non-RA controls, including an osteoarthritis (OA) subgroup. RACP, anti-CCP, RF, and AKA levels were measured by enzyme-linked immunosorbent assay (ELISA). Diagnostic sensitivity, specificity, and combination strategies were assessed using chi-square and <i>t</i>-tests.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>RACP alone demonstrated a sensitivity of 76.86% and a specificity of 89.94%, closely comparable to anti-CCP (70.87% sensitivity and 89.92% specificity). Area under the curve (AUC) values were 0.805 for RACP, 0.783 for RF, 0.799 for anti-CCP, and 0.623 for AKA. Combining RACP with RF improved sensitivity (85.36%), while dual positivity (RACP + AKA) optimized specificity (96.61%). In the OA subgroup, biomarker positivity remained minimal, confirming strong discriminatory capacity. Patients positive for RACP or anti-CCP exhibited significantly higher tender joint counts, correlating biomarker positivity with clinical disease severity.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>RACP is a robust biomarker for RA diagnosis, offering sensitivity and specificity comparable to or exceeding traditional assays. Combinations with RF or anti-CCP enhance diagnostic accuracy, supporting its utility in early RA detection, differential diagnosis from OA, and potentially reflecting disease activity. Prospective studies are warranted to confirm these findings.</p>\n </section>\n </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Value of Rheumatoid Arthritis Citrullinated Peptides (RACP) System in the Diagnosis of Rheumatoid Arthritis: A Retrospective Analysis of 2632 Patients\",\"authors\":\"Kun Yang, Sixing Li, Leting Zheng, Fei Dong, Jing Wen, Zhendong He, Jiale Wen, Fang Qin\",\"doi\":\"10.1111/1756-185x.70393\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives and Aim</h3>\\n \\n <p>This study aimed to evaluate the diagnostic accuracy and prognostic value of the Rheumatoid Arthritis Citrullinated Peptides (RACP) assay in a real-world cohort, assessing its performance both independently and in combination with established biomarkers such as anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), and anti-keratin antibodies (AKA).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A single-center retrospective analysis included 2632 patients who underwent serological testing between September 2022 and September 2023. Of these, 644 patients met ACR/EULAR classification criteria for rheumatoid arthritis (RA), while 1988 patients served as non-RA controls, including an osteoarthritis (OA) subgroup. RACP, anti-CCP, RF, and AKA levels were measured by enzyme-linked immunosorbent assay (ELISA). Diagnostic sensitivity, specificity, and combination strategies were assessed using chi-square and <i>t</i>-tests.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>RACP alone demonstrated a sensitivity of 76.86% and a specificity of 89.94%, closely comparable to anti-CCP (70.87% sensitivity and 89.92% specificity). Area under the curve (AUC) values were 0.805 for RACP, 0.783 for RF, 0.799 for anti-CCP, and 0.623 for AKA. Combining RACP with RF improved sensitivity (85.36%), while dual positivity (RACP + AKA) optimized specificity (96.61%). In the OA subgroup, biomarker positivity remained minimal, confirming strong discriminatory capacity. Patients positive for RACP or anti-CCP exhibited significantly higher tender joint counts, correlating biomarker positivity with clinical disease severity.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>RACP is a robust biomarker for RA diagnosis, offering sensitivity and specificity comparable to or exceeding traditional assays. Combinations with RF or anti-CCP enhance diagnostic accuracy, supporting its utility in early RA detection, differential diagnosis from OA, and potentially reflecting disease activity. Prospective studies are warranted to confirm these findings.</p>\\n </section>\\n </div>\",\"PeriodicalId\":14330,\"journal\":{\"name\":\"International Journal of Rheumatic Diseases\",\"volume\":\"28 8\",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Rheumatic Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1756-185x.70393\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Rheumatic Diseases","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1756-185x.70393","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
The Value of Rheumatoid Arthritis Citrullinated Peptides (RACP) System in the Diagnosis of Rheumatoid Arthritis: A Retrospective Analysis of 2632 Patients
Objectives and Aim
This study aimed to evaluate the diagnostic accuracy and prognostic value of the Rheumatoid Arthritis Citrullinated Peptides (RACP) assay in a real-world cohort, assessing its performance both independently and in combination with established biomarkers such as anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), and anti-keratin antibodies (AKA).
Methods
A single-center retrospective analysis included 2632 patients who underwent serological testing between September 2022 and September 2023. Of these, 644 patients met ACR/EULAR classification criteria for rheumatoid arthritis (RA), while 1988 patients served as non-RA controls, including an osteoarthritis (OA) subgroup. RACP, anti-CCP, RF, and AKA levels were measured by enzyme-linked immunosorbent assay (ELISA). Diagnostic sensitivity, specificity, and combination strategies were assessed using chi-square and t-tests.
Results
RACP alone demonstrated a sensitivity of 76.86% and a specificity of 89.94%, closely comparable to anti-CCP (70.87% sensitivity and 89.92% specificity). Area under the curve (AUC) values were 0.805 for RACP, 0.783 for RF, 0.799 for anti-CCP, and 0.623 for AKA. Combining RACP with RF improved sensitivity (85.36%), while dual positivity (RACP + AKA) optimized specificity (96.61%). In the OA subgroup, biomarker positivity remained minimal, confirming strong discriminatory capacity. Patients positive for RACP or anti-CCP exhibited significantly higher tender joint counts, correlating biomarker positivity with clinical disease severity.
Conclusion
RACP is a robust biomarker for RA diagnosis, offering sensitivity and specificity comparable to or exceeding traditional assays. Combinations with RF or anti-CCP enhance diagnostic accuracy, supporting its utility in early RA detection, differential diagnosis from OA, and potentially reflecting disease activity. Prospective studies are warranted to confirm these findings.
期刊介绍：
The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.
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