Sandborn W J, Loftus E V, Colombel J F, Fleming K A, Seibold F, Homburger H A, Sendid B, Chapman R W, Tremaine W J, Kaul D K, Wallace J, Harmsen W S, Zinsmeister A R, Targan S R
Mayo Clinic, Rochester, Minnesota 55905, USA.
Inflamm Bowel Dis. 2001 Aug;7(3):192-201. doi: 10.1097/00054725-200108000-00003.
The sensitivity of assays for antineutrophil cytoplasmic antibody (ANCA), anti-Saccharomyces cerevisiae antibody (ASCA), and antipancreatic antibody (PAB) in different laboratories is unknown. Likewise, the sensitivity and diagnostic usefulness of these assays in patients with inflammatory bowel disease (IBD) in the community is unknown.
An incidence cohort of 290 patients with IBD were offered participation in the study. Blood was obtained from 162 patients (56%) (83 with ulcerative colitis, 79 with Crohn's disease) who agreed to participate. ANCA was determined in five laboratories. ASCA in two laboratories, and PAB in one laboratory.
In ulcerative colitis, the sensitivity of ANCA determined in five laboratories varied widely, ranging from 0-63%. In Crohn's disease, the sensitivity of ASCA determined in two laboratories did not vary significantly, ranging from 39-44%; and the sensitivity of PAB determined in one laboratory was 15%. The optimal diagnostic usefulness was obtained from one laboratory where the positive predictive values of a positive ANCA assay combined with a negative ASCA assay for ulcerative colitis, and a negative ANCA combined with a positive ASCA for Crohn's disease, were 75% and 86%, respectively.
In patients with IBD, the sensitivity of ANCA varied widely in different laboratories, whereas the prevalence of ASCA was similar. The positive predictive values of the ANCA assay combined with the ASCA assay for ulcerative colitis and Crohn's disease are high enough to be clinically useful.
不同实验室中抗中性粒细胞胞浆抗体（ANCA）、抗酿酒酵母抗体（ASCA）和抗胰腺抗体（PAB）检测的敏感性尚不清楚。同样，这些检测在社区炎症性肠病（IBD）患者中的敏感性和诊断价值也不清楚。
邀请290例IBD患者的发病队列参与研究。从162例（56%）同意参与的患者（83例溃疡性结肠炎患者，79例克罗恩病患者）中采集血液。在五个实验室检测ANCA，在两个实验室检测ASCA，在一个实验室检测PAB。
在溃疡性结肠炎中，五个实验室检测ANCA的敏感性差异很大，范围为0%至63%。在克罗恩病中，两个实验室检测ASCA的敏感性差异不显著，范围为39%至44%；一个实验室检测PAB的敏感性为15%。在一个实验室中获得了最佳诊断价值，其中溃疡性结肠炎患者ANCA检测阳性且ASCA检测阴性以及克罗恩病患者ANCA检测阴性且ASCA检测阳性的阳性预测值分别为75%和86%。
在IBD患者中，不同实验室检测ANCA的敏感性差异很大，而ASCA的患病率相似。ANCA检测与ASCA检测联合用于溃疡性结肠炎和克罗恩病的阳性预测值足够高，具有临床应用价值。
