Detection and significance of serum cross-linked carboxyterminal telopeptide region of type I collagen and matrix metalloproteinase enzyme-3 in patients with early rheumatoid arthritis

Objective To investigate the significance of cross-linked carboxyterminal telopeptide region of type Ⅰ collagen(ICTP),matrix metalloproteinase-3(MMP-3),anti-cyclic citrullinated peptide(CCP) antibody,rheumatoid factor(RF) and rheumatoid arthritis(RA) activity in the early diagnosis of RA.Methods The enzyme-linked immunosorbent assay(ELISA) was used to determine the serum samples of 213 patients with RA(early RA group: 92 cases and medium-and long-term RA group: 121 cases),43 patients with non-RA associated and immune diseases and 40 healthy controls.The serum ICTP,MMP-3 and anti-CCP antibody were determined.The serum RF was determined by immunoturbidimetry.Results The optimal cut-off values of ICTP,MMP-3 and anti-CCP antibody in the diagnosis of early RA were 3.21 μg/L,67.45 ng/mL,15.45 U/mL and 12.35 U/mL.The sensitivities were 74.0%,63.4%,52.4% and 55.3%,and the specificities were 95.5%,81.8%,95.5% and 90.9%.RF and anti-CCP antibody were higher in the RA group than in the healthy control group and the non-RA group(P0.01).ICTP,MMP-3 and RF in the non-RA group and the healthy control group had statistical significance(P0.01).ICTP in early RA and non-RA group had no statistical significance(P0.05).The ICTP,MMP-3,anti-CCP antibody and RF of X ray staging Phase Ⅰ had statistical significances with those staging Phase Ⅱ,Ⅲ and Ⅳ(P0.05,P0.01).The ICTP,MMP-3 and anti-CCP antibody of Phase Ⅱ with those of Phase Ⅲ and Ⅳ had statistical significance(P0.05,P0.01).The RF among Phase Ⅱ,Ⅲ and Ⅳ had no statistical significance(P0.05).Conclusions The simultaneous detection of ICTP,MMP-3,anti-CCP antibody and RF can improve accuracy and reduce missed diagnosis.Dynamic combination detection can monitor effectively the progression of RA.