Anti-Cyclic Citrullinated Peptide
Label Mnemonic: CCP
Epic code: LAB1254
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
6240 RCP
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Red top tube 5 mL (Clot Activator)
3 mL light green top (PST) tube or TWO Microtainer® devices
Delivery Instructions:
Deliver to laboratory within 2 hours of collection.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
2 hours (upon receipt in laboratory)
Reference Range:
<3.0 U/mL
Assay methodology and reference range changed November 11, 2014.

A positive result for cyclic citrullinated peptide (anti-CCP) antibodies indicates a high likelihood of rheumatoid arthritis (RA). Anti-CCP antibodies have also been reported in approximately 40% of seronegative RA patients, and, like rheumatoid factor (RF), a positive CCP antibody result indicates an increased likelihood of erosive disease in patients with RA.

Anti-CCP values determined on patient samples by different testing procedures cannot be directly compared with one another and could be the cause of erroneous medical interpretations.

1. Banal F, Dougados M, Combescure C, Gossec L: Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systemic literature review and meta-analysis. Ann Rheum Dis 2009 July;68:1184-1191

2. Schellekens GA, Visser H, De Jong BA, et al: The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 2000 Jan;43(1):155-163

3. Visser H, le Cessie S, Vos, K, et al: How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum 2002 Feb;46(2):357-365
Test Limitations:
Immune complexes or other immunoglobulin aggregates present in patient samples may cause non-specific binding and false positive results. There is possibility of cross-reactivity in patients with anti- Centromere, anti-SS-A, and myeloma IgG.

Contaminated, icteric, lipemic, hemolyzed, or heat inactivated sera may cause erroneous results and should be avoided.
Multiplex Flow Immunoassay
CPT Code: