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Background: There is no gold standard for the diagnosis and monitoring of inflammatory bowel disease (IBD).As immune system plays crucial role in the pathogenesis of IBD,some immune-specific serum antibodies are considered to be useful tools for the diagnosis and differential diagnosis of the disease.Aims: To investigate the clinical significance of serum antibodies,including anti-Saccharomyces cerevisiae antibody (ASCA) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in IBD.Methods: Serum samples were obtained from 91 consecutive IBD patients from Feb.2015 to May 2016 at the First Affiliated Hospital of Soochow University.Of them,52 were Crohn's disease (CD) and 39 were ulcerative colitis (UC).Serum samples of 36 non-IBD patients were served as controls.ASCA-IgG and ASCA-IgA were detected by ELISA,and pANCA by indirect immunofluorescence assay.Using clinical diagnosis as gold standard,crosstabs statistics was performed to measure the diagnostic accuracy of ASCA and pANCA,and ROC curve,Pearson Chi-square test and Fisher's exact test were employed for analyzing the correlations of these two serum antibodies with IBD,CD,UC,and the location of the disease.Results: Both serum ASCA-IgG and IgA were correlated with CD (AUC=0.626 and 0.614),while UC was correlated with ASCA-IgA only (AUC=0.486).Serum pANCA had relevance to IBD (r=0.342),CD (r=-0.262) and UC (r=0.614);its sensitivity and specificity for IBD and UC were superior to those for CD (P＜0.05).In CD patients,ASCA-IgG was associated with terminal ileal disease (P＜0.05),and pANCA was associated with colonic involvement (P＜0.05).In UC patients,both ASCA-IgG and IgA were correlated with terminal ileal disease (P＜0.05).Conclusions: Serum ASCA and pANCA may be helpful for discrimination between CD and UC when the diagnosis of IBD is established.Furthermore,they are closely associated with the disease location,ASCA is related with the terminal ileal disease and pANCA is related with colonic involvement.
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Objective To investigate clinical significance of diagnosis of the anti saccharomyces cerevisiae antibody (ASCA), pancreatic acini antibody (PAB)resistance,resistance to small goblet cell antibody (GAB),anti neutrophil cytoplasm anti-bodies (ANCA)for inflammatory bowel disease (IBD)and the differential diagnosis of ulcerative colitis (UC)and crohn's disease (CD).Methods Collected 200 cases of test group sets of inflammatory bowel disease,serum by indirect immunofluo-rescence (IF).Results In the serum of 200 patients,106 cases with positive or weakly positive.Among them,the positive ASCA/weak positive 24 cases,14 cases of PAB,GAB 63 cases,28 cases ANCA,and included in ASCA group respectively and PAB group,GAB group,ANCA group.Positive rate of ANCA and GAB in the diagnosis of UC were 34% and 58%. Positive rate of ASCA and PAB in the diagnosis of CD were 28.6% and 38.1%.ANCA associated with GAB detection in the diagnosis of UC specific degree was 60%,ASCA associated with PAB detection in the diagnosis of CD specific degree was 75%.Conclusion Serum inflammatory bowel disease antibody spectrum in ASCA,ANCA,GBA and PAB four antibod-ies of joint detection has important guiding value to the diagnosis of IBD,also can be used as one of UC and CD in the differ-ential diagnosis methods.
RESUMO
Background: Several studies have suggested that Anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) are useful serological markers associated with inflammatory bowel disease (IBD). However, neither the indication nor its use in clinical practice have been clearly established. Aim: to assess whether the presence of these markers have a possible diagnostic role and clinical significance. Patients and Methods: Retrospective chart review of 93 patients, average age 42 years, 48 female. ASCA and p-ANCA were determinated by ELISA and IFI. The sensitivity (S), specificity (E), positive and negative predictive values (PPV and NPV), and X2 were determinated. Results: Sixty eight patients with IBD (35 Crohn´s disease (CD), 31 ulcerative colitis (UC), one IBD unclassified and one indeterminate colitis patients) and 25 patients with other gastrointestinal diseases. In the total group of patients the S and E of ASCA and p-ANCA for diagnosis of CD and UC was 48.6 percent, 74.1 percent and 77.4 percent, 82.3 percent respectively. In patients with IBD, the presence of ASCA(+)/p-ANCA(-) had a S, E, PPV, and NPV for diagnosis of CD 37.1 percent, 93.5 percent, 86.7 percent and 56.9 percent respectively. On the other hand, the presence of ASCA(-)/p-ANCA(+) had a S, E, PPV, and NPV for diagnosis of UC 64.5 percent, 85.7 percent, 80 percent and 73.1 percent respectively. The evolution of IBD patients was not associated with the presence of these markers. Conclusions: Our study showed that both p-ANCA and ASCA did not have an important role in the differential diagnosis of CD and UC and in their prognosis. New strategies to differentiate CD and UC and to determinate their prognosis are needed.
Existen estudios que han sugerido que los anticuerpos Anti-Saccharomyces cerevisiae (ASCA) y los anticuerpos anticitoplasma de los neutrófilos perinuclear (p-ANCA), son marcadores serológicos asociados a las enfermedades inflamatorias intestinales (EII). Sin embargo, su indicación y uso en la práctica clínica no han sido aún clarificados. Objetivos: Evaluar si la presencia de estos marcadores posee algún papel en el diagnóstico y pronóstico. Pacientes y Métodos: Noventa y tres pacientes, edad promedio 42 años, 48 mujeres. Los anticuerpos ASCA fueron determinados por técnica de ELISA y los p-ANCA por IFI. Se calculó la sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y negativo (VPN) y X2. Resultados: Se incluyen sesenta y siete pacientes con EII (35 enfermedad de Crohn (EC), 31 colitis ulcerosa (CU), uno con EII no clasificable y un paciente con Colitis Indeterminada) y 25 pacientes con otras enfermedades gastrointestinales. En el grupo total de pacientes, la S y E de ASCA y p-ANCA para el diagnóstico de EC y CU fue de 48,6 y 74,1 por ciento y 77,4 y 82,3 por ciento respectivamente. En pacientes con diagnóstico establecido de EII, la presencia de ASCA(+)/p-ANCA(-) tuvo una S, E, VPP y VPN para el diagnóstico de EC 37,1, 93,5, 86,7 y 56,9 por ciento, respectivamente. Por otro lado, la presencia de ASCA(-)/p-ANCA(+) tuvo una S, E, VPP y VPN para el diagnóstico de CU 64,5, 85,7, 80 y 73,1 por ciento, respectivamente. La evolución favorable o desfavorable de los pacientes con EII (EC o CU) no se correlacionó con la presencia (positividad) de uno o ambos marcadores (p ≥ 1). Conclusiones: Nuestro estudio demostró que los marcadores serológicos ASCA y ANCA utilizados en conjunto no poseen actualmente un papel importante en la diferenciación de la EC de la CU, como tampoco para establecer un pronóstico de su evolución. Por lo tanto, es necesario encontrar nuevas estrategias para poder diferenciar estos dos cuadros y poder determinar...