Papp Maria, Norman Gary L, Altorjay Istvan, Lakatos Peter Laszlo
World J Gastroenterol. 2007 Apr 14;13(14):2028-36. doi: 10.3748/wjg.v13.i14.2028.
The panel of serologic markers for inflammatory bowel diseases (IBD) is rapidly expanding. Although anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophil cytoplasmic antibodies (P-ANCA) remain the most widely investigated, an increasing amount of experimental data is available on newly discovered antibodies directed against various microbial antigens. The role of the assessment of various antibodies in the current IBD diagnostic algorithm is often questionable due to their limited sensitivity. In contrast, the association of serologic markers with disease behavior and phenotype is becoming increasingly well-established. An increasing number of observations confirms that patients with Crohn's disease expressing multiple serologic markers at high titers are more likely to have complicated small bowel disease (e.g. stricture and/or perforation) and are at higher risk for surgery than those without, or with low titers of antibodies. Creating homogenous disease sub-groups based on serologic response may help develop more standardized therapeutic approaches and may help in a better understanding of the pathomechanism of IBD. Further prospective clinical studies are needed to establish the clinical role of serologic tests in IBD.
炎症性肠病（IBD）的血清学标志物组合正在迅速扩展。尽管抗酿酒酵母抗体（ASCA）和非典型核周型抗中性粒细胞胞浆抗体（P-ANCA）仍是研究最为广泛的，但关于针对各种微生物抗原的新发现抗体的实验数据越来越多。由于各种抗体的敏感性有限，它们在当前IBD诊断算法中的评估作用往往存疑。相比之下，血清学标志物与疾病行为和表型之间的关联越来越明确。越来越多的观察结果证实，高滴度表达多种血清学标志物的克罗恩病患者比那些不表达或低滴度抗体的患者更易出现复杂的小肠疾病（如狭窄和/或穿孔），手术风险也更高。基于血清学反应创建同质的疾病亚组可能有助于开发更标准化的治疗方法，并有助于更好地理解IBD的发病机制。需要进一步的前瞻性临床研究来确定血清学检测在IBD中的临床作用。
