Comparative study of different enzyme immunoassays for measurement of IgM and IgA rheumatoid factors
Comparative study of different enzyme immunoassays for measurement of IgM and IgA rheumatoid factors
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DOI：
10.1136/ard.61.6.505
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发表时间：
2002-06-01
影响因子：
27.4
通讯作者：
Vischer, TL
中科院分区：
文献类型：
--
作者：
Bas, S;Perneger, TV;Vischer, TL
目的：比较IgM、伊加类风湿因子（RF）检测对类风湿关节炎（RA）的诊断价值。首先，乳胶测试，一个全球性的测试，在一个特别具有挑战性的情况下，比较了6种IgM和4种伊加RF测定法（对于IgM、伊加和IgG RF），也就是说，有67名RA患者，其中许多人是乳胶阴性的，和91名非RA对照，很多人都是乳胶阳性更详细的评估，随后与三个IgM RF测试（两个市售试剂盒和一个在我们的实验室开发的检测）和两个伊加RF测试（一个市售和一个从我们的实验室）在两个更有代表性的样本的风湿病患者（146 RA和75非RA控制）。对于IgM RF检测，Diamethrin试剂盒获得最高灵敏度（88%）（特异性67%），对于伊加RF，Inova试剂盒获得最高灵敏度（65%，特异性88%）。当两种检测结果一致时，结合一种IgM和一种伊加RF检测可以提高诊断性能，但代价是产生15-27%的不一致结果，这无助于裁定RA的存在或不存在。IgM RF测试之间的平均浓度值差异显着，在大多数情况下，浓度不相关。结论：可用的测试IgM RF同种型的准确性不同，没有一个是均匀优于所有其他。对于伊加RF同种型，Inova试剂盒似乎是最好的。定量结果不能在测试之间进行比较。一个IgM和一个伊加RF测试的组合可能会提高诊断的准确性。
Objective: To compare the value of various IgM and IgA rheumatoid factor (RF) tests for the diagnosis of rheumatoid arthritis (RA).Methods: Firstly, the latex test, one global assay (for IgM, IgA, and IgG RF), six IgM, and four IgA RF assays were compared in a particularly challenging situation-that is, with 67 patients with RA, many of whom were latex negative, and 91 non-RA controls, many of whom were latex positive. More detailed evaluation followed with three IgM RF tests (two commercially available kits and one assay developed in our laboratory) and two IgA RF tests (one commercially available and one from our laboratory) in two more representative samples of rheumatological patients (146 RA and 75 non-RA controls).Results: Diagnostic performance differed considerably between the assays. For IgM RF detection the highest sensitivity (88%) was obtained with the Diamedix kit (specificity 67%) and for IgA RF with the Inova kit (sensitivity 65%, specificity 88%). Combining one IgM and one IgA RF test improved diagnostic performance when both tests were in agreement, but at the cost of yielding 15-27% of discrepant results which did not help in ruling RA in or out. Mean concentration values differed significantly among IgM RF tests, and in most cases concentrations were not correlated.Conclusions: Available tests for IgM RF isotype vary in accuracy, and none is uniformly better than all the others. For IgA RF isotype, the Inova kit appears to be the best. Quantitative results cannot be compared across tests. Combination of one IgM and one IgA RF test may improve diagnostic accuracy.