Combined testing of immunological indicators in diagnosis of rheumatoid arthritis

Luo Jing

doi:10.3969/j.issn.1674-7151.2025.03.013

Abstract：Objective To investigate the application of combined detection of immunological indicators in diagnosis of rheumatoid arthritis(RA).Methods The 120 cases of RA patients admitted to Beijing Jishuitan Hospital Guizhou Hospital from July 2023 to July 2024 were selected as research objects and included in RA group,and 60 healthy objects with physical examination were selected as control group.The level of rheumatoid factor(RF)was detected by immunoturbidimetry in all subjects,enzyme linked immunosorbent assay(ELISA)was used to detect anti-cyclic citrullinated peptide antibody(anti-CCP)and anti-rheumatoid arthritis 33 antibody(anti-RA33),and flow cytometry combined with laser scattering technique was used to detect neutrophil to lymphocyte ratio(NLR).The differences of the above immunological indexes between two groups were analyzed.The receiver operator characteristic curve(ROC curve)was drawn and the area under ROC curve(AUC)was calculated.The diagnostic efficacy of each index for RA was analyzed.Results The levels of RF,anti-CCP,NLR and anti-RA33 in RA group were significantly higher than those in control group[RF(U/L):25.50±3.30 vs.20.34±2.24;anti-CCP(kU/L):9.41±5.50 vs.6.41±4.27;NLR:4.61±1.40 vs.1.84±0.63;anti-RA33(kU/L):8.41±6.63 vs.7.68±6.40;all P<0.05].The AUC of combined detection of RF,anti-CCP,NLR and anti-RA33 in diagnosis of RA was significantly higher than those of single detection(0.973 vs.0.611,0.819,0.875,0.832,all P<0.05).The sensitivity of combined detection was significantly higher than those of RF and anti-CCP alone(93.33%vs.70.00%,76.67%,both P<0.05),but there was no significant difference compared with NLR and anti-RA33(93.33%vs.90.00%,95.83%,both P>0.05).The diagnostic specificity and accuracy of combined detection were significantly higher than those of indicators detected alone(specificity:95.00%vs.73.33%,83.33%,80.00%,61.67%;accuracy:93.89%vs.71.11%,78.89%,86.67%,84.44%;all P<0.05).Conclusion The combined detection of RF,anti-CCP,NLR and anti-RA33 could significantly improve the diagnostic sensitivity and specificity of RA,optimize the early diagnosis process of RA,and provide more accurate basis for clinical decision-making.