Diagnostic accuracy of anti-MCV and anti-CCP antibodies in rheumatoid arthritis A meta-analysis

Abstract

Objective The purpose of this study was to compare the diagnostic performance of anti-mutated citrullinated vimentin (anti-MCV) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA).

Methods We searched the Medline, Embase, and Cochrane library databases and performed two meta-analyses on the diagnostic accuracy of anti-MCV and anti-CCP in patients with RA compared to healthy controls.

Results We identified 12 studies that included a total of 2003 RA patients and 831 healthy controls for the meta-analysis. The pooled sensitivity and specificity of anti-MCV were 68.6 % [95 % confidence interval (CI) 66.6–79.7] and 94.2 % (95 % CI 92.4–96.7) and those of anti-CCP were 61.7 % (95 % CI 59.5–63.8) and 97.1 % (95 % CI 96.7–98.1), respectively. Anti-MCV PLR, NLR, and DOR were 12.99 (95 % CI 8.013–21.27), 0.297 (95 % CI 0.238–0.369), and 47.78 (95 % CI 28.59–79.84), and those for anti-CCP were 16.71 (95 % CI 11.42–24.47), 0.378 (95 % CI 0.325–0.439), and 54.20 (95 % CI 31.65–92.82), respectively. The AUC of anti-MCV was 0.886, and its Q* index was 0.817, indicating modest accuracy, while the AUC of anti-CCP was 0.946, and its Q* index was 0.885. The sensitivity of anti-MCV was significantly higher than that of anti-CCP in the diagnosis of RA (difference 0.069, 95 % CI 0.039–0.098, p < 0.0001), but the specificity of anti-MCV was lower than that of anti-CCP (difference − 0.029, 95 % CI − 0.051 to − 0.006, p = 0.012). The Q* index of anti-MCV was significantly lower than that of anti-CCP (difference − 0.068, 95 % CI − 0.070 to − 0.065, p < 0.0001).

Conclusion Our meta-analysis demonstrates that anti-MCV is more sensitive but less specific, and has lower diagnostic accuracy than anti-CCP in RA, although anti-MCV and anti-CCP showed comparable high PLRs.