Comparative assessment of sensitivity and specificity of three variants of classification criteria for systemic lupus erythematosus in a cohort of Russian patients
- 作者: Reshetnyak T.1, Lisitsyna T.1, Cheldieva F.1, Shumilova A.1, Glukhova S.1, Starovoytova M.1, Seredavkina N.1, Desinova O.1, Verizhnikova Z.1, Nasonov E.1
-
隶属关系:
- Nasonova Research Institute of Rheumatology
- 期: 卷 95, 编号 5 (2023)
- 页面: 410-417
- 栏目: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/132958
- DOI: https://doi.org/10.26442/00403660.2023.05.202201
- ID: 132958
如何引用文章
全文:
详细
Background. The clinical and serologic heterogeneity of systemic lupus erythematosus (SLE) presents challenges for diagnosis, particularly in the earliest stages of the disease when there are insufficient signs to make a reliable diagnosis.
Aim. To make a comparative assessment of sensitivity and specificity of various classification criteria of SLE on a cohort of patients of Nasonova Research Institute of Rheumatology.
Materials and methods. A total of 252 patients were included in the study; 152 (60%) of 252 patients had reliable SLE (mean age 36 [29.5–46] years, duration of disease 9 [3.4–19] years). Of 252 patients, 26 (11%) had PAPS (mean age 36.5 [31–42] years, duration of disease 4.6 [1–10.4] years). Systemic sclerosis was diagnosed in 74/252 (29%) patients, (mean age 51.5 [42–59] years, duration of disease 9 [5–16] years). The quality of the classification function of the criteria was assessed by ROC analysis.
Results. SLE was diagnosed in 131 (86%) of 152 patients using the American College of Rheumatology – ACR)-1997 criteria, in 145 (95%) using the The Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria, and in 144 (94.7%) using the European League Against Rheumatism (EULAR)/ACR 2019 criteria. ANF positivity was the least statistically significant of all signs in relation to the diagnosis of SLE. The area under the curve (AUC) for ANF≥1/160 titers was AUC 0.654 for the ACR-97 criteria, AUC 0.616 for the SLICC-12 SLE criteria, and AUC 0.609 for the 2019 EULAR/ACR criteria. ROC analysis of the relationship between the number of criteria/points and a reliable diagnosis of SLE revealed a high diagnostic accuracy – the AUC for all SLE criteria was greater than 0.940. In the ROC analysis of patients with SLE and PAFS, indicating the number of diagnostic criteria, sensitivity was 86% for ACR-1997, 95% for SLICC-2012, 95% for EULAR/ACR 2019, and specificity was 100, 62 and 62%, respectively.
Conclusion. The classification criteria SLICC-2012 and EULAR/ACR 2019 are more sensitive for the diagnosis of SLE in the Russian population, and the criteria ACR-1997 are more specific. All three variants of the SLE classification criteria have sufficient sensitivity and specificity for their use in real clinical practice.
作者简介
Tatiana Reshetnyak
Nasonova Research Institute of Rheumatology
编辑信件的主要联系方式.
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0003-3552-2522
доктор медицинских наук, профессор, зав. лабораторией
俄罗斯联邦, MoscowTatiana Lisitsyna
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0001-9437-406X
доктор медицинских наук, ведущий научный сотрудник
俄罗斯联邦, MoscowFariza Cheldieva
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0001-5217-4932
научный сотрудник
俄罗斯联邦, MoscowAnastasiia Shumilova
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0003-1318-1894
врач-ревматолог
俄罗斯联邦, MoscowSvetlana Glukhova
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0002-4285-0869
кандидат медицинских наук, старший научный сотрудник
俄罗斯联邦, MoscowMayya Starovoytova
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0002-1004-9647
кандидат медицинских наук, старший научный сотрудник
俄罗斯联邦, MoscowNataliya Seredavkina
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0001-5781-2964
кандидат медицинских наук, научный сотрудник
俄罗斯联邦, MoscowOxana Desinova
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0002-0283-9681
кандидат медицинских наук, научный сотрудник
俄罗斯联邦, MoscowZhanna Verizhnikova
Nasonova Research Institute of Rheumatology
Email: t_reshetnyak@yahoo.com
ORCID iD: 0000-0002-4829-5210
кандидат медицинских наук, младший научный сотрудник
俄罗斯联邦, MoscowEvgeny Nasonov
Nasonova Research Institute of Rheumatology
Email: nasonov@irramn.ru
ORCID iD: 0000-0002-1598-8360
Академик РАН, доктор медицинских наук, профессор, научный руководитель
俄罗斯联邦, Moscow参考
- Yu C, Gershwin ME, Chang C. Diagnostic criteria for systemic lupus erythematosus: a critical review. J Autoimmun. 2014;48-49:10-3. doi: 10.1016/j.jaut.2014.01.004
- Cohen AS, Reynolds WE, Franklin EC, et al. Preliminary criteria for the classification of systemic lupus erythematosus. Bull Rheum Dis. 1971;21:643-8.
- Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25(11):1271-7. doi: 10.1002/art.1780251101
- Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725. doi: 10.1002/art.1780400928
- Passas CM, Wong RL, Peterson M, et al. A comparison of the specificity of the 1971 and 1982 American Rheumatism Association criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1985;28:620-3. doi: 10.1002/art.1780280604
- Gilboe IM, Husby G. Application of the 1982 revised criteria for the classification of systemic lupus erythematosus on a cohort of 346 Norwegian patients with connective tissue disease. Scand J Rheumatol. 1999;28:81-7. doi: 10.1080/030097499442531
- Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677-86. doi: 10.1002/art.34473
- Aringer M. EULAR/ACR classification criteria for SLE. Semin Arthritis Rheum. 2019;49(3S):S14-7. doi: 10.1016/j.semarthrit.2019.09.009
- Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295-306. doi: 10.1111/j.1538-7836.2006.01753.x
- Van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2013;72(11):1747-55. doi: 10.1136/annrheumdis-2013-204424
- Magallares B, Lobo-Prat D, Castellví I, et al. J Clin Med. 2021;10(11):2377. doi: 10.3390/jcm10112377
- Tan BCH, Tang I, Bonin J, et al. The performance of different classification criteria for systemic lupus erythematosus in a real-world rheumatology department. Rheumatology (Oxford). 2022;61(11):4509-13. doi: 10.1093/rheumatology/keac120
- Bakula M, Cikes N, Anic B. Validation of the new classification criteria for systemic lupus erythematosus on a patient cohort from a national referral center: a retrospective study. Croat Med J. 2019;60(4):333-44. doi: 10.3325/CroatMedJ_60_0325
- Inês L, Silva C, Galindo M, et al. Classification of Systemic Lupus Erythematosus: Systemic Lupus International Collaborating Clinics Versus American College of Rheumatology Criteria. A Comparative Study of 2,055 Patients From a Real-Life, International Systemic Lupus Erythematosus Cohort. Arthritis Care Res (Hoboken). 2015;67(8):1180-5. doi: 10.1002/acr.22539
- Fonseca AR, Gaspar-Elsas MI, Land MG, et al. Comparison between three systems of classification criteria in juvenile systemic lupus erythematous. Rheumatology (Oxford). 2015;54(2):241-7. doi: 10.1093/rheumatology/keu278
- Lythgoe H, Morgan T, Heaf E, et al. Evaluation of the ACR and SLICC classification criteria in juvenile-onset systemic lupus erythematosus: a longitudinal analysis. Lupus. 2017;26(12):1285-90. doi: 10.1177/0961203317700484
- Suda M, Kishimoto M, Ohde S, et al. Validation of the 2019 ACR/EULAR classification criteria of systemic lupus erythematosus in 100 Japanese patients: a real-world setting analysis. Clin Rheumatol. 2020;39(6):1823-7. doi: 10.1007/s10067-019-04848-z
- Assan F, Seror R, Mariette X, et al. New 2019 SLE EULAR/ACR classification criteria are valuable for distinguishing patients with SLE from patients with pSS. Ann Rheum Dis. 2021;80(8):e122. doi: 10.1136/annrheumdis-2019-2162.