Serum connective tissue growth factor is a highly discriminatory biomarker for the diagnosis of rheumatoid arthritis.
Serum connective tissue growth factor is a highly discriminatory biomarker for the diagnosis of rheumatoid arthritis.
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血清结缔组织生长因子是诊断类风湿性关节炎的高度辨别性生物标志物。
DOI：
10.1186/s13075-017-1463-1
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发表时间：
2017-11-22
影响因子：
4.9
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Yang X;Lin K;Ni S;Wang J;Tian Q;Chen H;Brown MA;Zheng K;Zhai W;Sun L;Jin S;Wang J
我们之前的蛋白质组学研究表明，结缔组织生长因子（CTGF）可能是类风湿性关节炎（RA）诊断的潜在生物标志物。目的是评估 CTGF 作为 RA 生物标志物的性能。使用直接高灵敏度夹心ELISA试剂盒检测血清和滑液CTGF。在 98 例 RA 病例和 103 名健康对照的训练队列中，测试了血清 CTGF 水平的辨别能力和最佳测定截止值。然后在 572 名患者（患有 RA (n = 217)、强直性脊柱炎 (n = 92)、痛风 (n = 74)、骨关节炎 (n = 52)、系统性红斑狼疮 (n = 72) 或原发性狼疮）的进一步队列中验证了测定性能。干燥综合征 (pSS) (n = 65))。 RA 患者滑液 CTGF 浓度显着升高，表现出出色的预测 RA 的诊断能力（曲线下面积 (AUC) = 0.97）。血清CTGF检测也有类似结果。在最佳截止值 88.66 pg/mL 下，训练队列中的敏感性、特异性和 AUC 分别为 0.86、0.92 和 0.92。在验证队列中观察到类似的表现，敏感性、特异性、阳性可能性和阴性可能性分别为 0.82、0.91、5.74 和 0.12。 CTGF 和抗瓜氨酸蛋白抗体 (ACPA) 联合使用 (AUC = 0.96) 比单独使用 ACPA 或类风湿因子 (RF) (AUC = 0.80 或 0.79) 具有更强的辨别能力。血清 CTGF 的区分性能在所有测试的炎症条件下都是一致的（所有病例中 AUC >0.92），唯一的例外是 pSS。血清 CTGF 不随症状持续时间或疾病活动度而变化。血清 CTGF 是一种很有前景的 RA 诊断生物标志物，在当前研究中的表现优于 ACPA 或 RF。本文的在线版本 (doi:10.1186/s13075-017-1463-1) 包含补充材料，可供授权用户使用。
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. 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 Sjögren’s syndrome (pSS) (n = 65)). 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. Serum CTGF is a promising diagnostic biomarker for RA, with performance in the current study better than either ACPA or RF. The online version of this article (doi:10.1186/s13075-017-1463-1) contains supplementary material, which is available to authorized users.
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