Blackwell P J, Hill P G, Holmes G K T
Dept. of Chemical Pathology, Derbyshire Royal Infirmary, Derby, UK.
Scand J Gastroenterol. 2002 Nov;37(11):1282-5. doi: 10.1080/003655202761020551.
Using selected sample populations, we compared sensitivity and specificity of autoantibodies to guinea pig and human tissue transglutaminase to assess if the human antigen is superior for predicting coeliac disease.
Four commercial enzyme-linked immunoassay kits using human tissue transglutaminase as antigen were used to measure autoantibody levels in serum samples from untreated adult coeliacs (n = 32). They were from a series of 130 cases diagnosed between 1997 and 1999 and chosen to bias the group towards subjects with negative autoantibodies when measured with guinea pig tissue transglutaminase as antigen. Samples from 38 control subjects (biased towards false-positive levels with guinea pig antigen) were used to compare specificity. We also assessed if human antigen kits could differentiate between levels in normal subjects and in selective IgA deficiency.
Sensitivity for coeliac disease in this selected group using the human antigen kits ranged from 88% to 100%. Three kits showed significantly higher specificity (82%-97%, P < 0.05) than the guinea pig antigen kit (71%) for the samples studied. No kit achieved complete separation between normal autoantibody levels and lower levels in selective IgA deficiency.
All human antigen kits showed significantly higher sensitivity for coeliac disease compared to guinea pig antigen (P < 0.001). Receiver operating characteristic curves confirmed the superior diagnostic accuracy of the human antigen kits.
我们使用选定的样本群体，比较了抗豚鼠和抗人组织转谷氨酰胺酶自身抗体的敏感性和特异性，以评估人抗原在预测乳糜泻方面是否更具优势。
使用四种以人组织转谷氨酰胺酶为抗原的商业酶联免疫吸附测定试剂盒，测量未经治疗的成年乳糜泻患者（n = 32）血清样本中的自身抗体水平。这些患者来自1997年至1999年间诊断的一系列130例病例，选择这些病例是为了使该组在以豚鼠组织转谷氨酰胺酶为抗原进行检测时偏向自身抗体阴性的受试者。使用38名对照受试者的样本（偏向于使用豚鼠抗原时出现假阳性水平）来比较特异性。我们还评估了人抗原试剂盒是否能够区分正常受试者和选择性IgA缺乏患者的水平。
使用人抗原试剂盒，该选定组中乳糜泻的敏感性范围为88%至100%。对于所研究的样本，三种试剂盒显示出比豚鼠抗原试剂盒（71%）显著更高的特异性（82% - 97%，P < 0.05）。没有试剂盒能够完全区分正常自身抗体水平和选择性IgA缺乏患者的较低水平。
与豚鼠抗原相比，所有人抗原试剂盒对乳糜泻均显示出显著更高的敏感性（P < 0.001）。受试者工作特征曲线证实了人抗原试剂盒具有更高的诊断准确性。
