ABSTRACT
Objective:To estimate the diagnostic value of anti-cyclic citrullinated peptide (CCP) antibody for juvenile idiopathic arthritis (JIA) by Meta-analysis.Methods:The databases, including Wanfang Database, VIP citation databases, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc, Excerpta Medica Database (EMbase), PubMed, Cochrane Library, were searched for the studies related to the diagnostic value of anti-CCP antibody for JIA. After extracting literature data and assessing the articles by Quality Assessment of Diagnostic Accuracy Studies tool. The sources of heterogeneity, sensitivity (SEN), specificity (SPE), area under the curve (AUC) were calculated by the summary receiver operator characteristic (SROC) curve by Stata 12.0 software.Results:A total of 30 literature reports were included in this Meta-analysis. The heterogeneity and the threshold effect of the included articles were tested, a mixed effects model was selected to calculate the pooled weighted SEN [0.16, 95% CI(0.11, 0.22)], SPE [0.99, 95% CI(0.98, 0.99)] and AUC [0.86, 95% CI(0.83, 0.89)]. The sensitivity estimates were highly heterogeneous, which was partially explained by the higher sensitivity in the rheumatoid factor-positive polyarthritis (RF+PA) subtypes [0.65, 95% CI (0.51, 0.76)] than in the other subtypes. The ability of diagnostic differentiation between of JIA and healthy children was better than the diagnostic differentiation between JIA and other patients ( Z=7.9, P<0.01). Conclusion:Although anti-CCP antibody cannot be used as an early diagnostic indicator of JIA, it can provide a certain guiding role in the initial screening and early treatment of the disease. CCP has clinical value in the differential diagnosis of RF+PA subtypes.