The University of Texas-Health Science Center at Houston, 6431 Fannin, MSB 5.232, Houston, TX 77030, USA.
J Rheumatol. 2009 Oct;36(10):2250-6. doi: 10.3899/jrheum.090340. Epub 2009 Sep 1.
To investigate the diagnostic accuracy of antimitochondrial antibodies (AMA), sp100, and gp210 antibodies for primary biliary cirrhosis (PBC) in a large population of patients with systemic sclerosis (SSc); to examine concordance of these antibodies with subsets of SSc. Further, to assess the association of SSc-related antibodies with hepatic parameter abnormalities.
We obtained medical records to verify the diagnoses of SSc and PBC. Sera from all participants were examined for the presence of SSc- and PBC-related antibodies, as well as for abnormalities in hepatic parameters.
We examined 817 patients with SSc, of whom 16 (2%) had confirmed PBC. The sensitivity and specificity of AMA by a MIT3 ELISA for PBC were 81.3% and 94.6%, respectively. Sp100 had a sensitivity and specificity of 31.3% and 97.4%, respectively, while gp210 had an even lower sensitivity. We were able to detect all PBC cases using AMA(MIT3) and sp100 as a combined marker, resulting in a significantly improved sensitivity of 100% (p = 0.042) with an incremental decrease in specificity to 92.6%. Independent of AMA or sp100 status, there was an association of anticentromere B (CENP-B) and anti-topoisomerase antibodies (ATA) with higher alkaline phosphatase levels (p = 0.051 and p = 0.003, respectively) while anti-RNA polymerase III (anti-RNAP) was associated with lower alkaline phosphatase levels (p = 0.019) among the patients with SSc.
Utilization of AMA(MIT3) and sp100 antibodies as a combined diagnostic marker leads to an improved detection of PBC in patients with SSc. CENP-B and ATA are associated with alkaline phosphatase elevation.
在系统性硬化症（SSc）患者的大人群中，研究抗线粒体抗体（AMA）、sp100 和 gp210 抗体对原发性胆汁性肝硬化（PBC）的诊断准确性；检查这些抗体与 SSc 亚群的一致性。此外，评估 SSc 相关抗体与肝参数异常的相关性。
我们获取病历以验证 SSc 和 PBC 的诊断。检查所有参与者血清中是否存在 SSc 和 PBC 相关抗体以及肝参数异常。
我们检查了 817 例 SSc 患者，其中 16 例（2%）患有确诊的 PBC。MIT3 ELISA 检测 AMA 对 PBC 的敏感性和特异性分别为 81.3%和 94.6%。Sp100 的敏感性和特异性分别为 31.3%和 97.4%，而 gp210 的敏感性更低。我们能够使用 AMA（MIT3）和 sp100 作为组合标记物检测到所有 PBC 病例，从而显著提高了 100%的敏感性（p = 0.042），特异性略有下降至 92.6%。无论 AMA 或 sp100 状态如何，抗着丝粒 B（CENP-B）和抗拓扑异构酶抗体（ATA）与碱性磷酸酶水平升高相关（p = 0.051 和 p = 0.003），而抗 RNA 聚合酶 III（抗 RNA 聚合酶）与碱性磷酸酶水平降低相关（p = 0.019）在 SSc 患者中。
使用 AMA（MIT3）和 sp100 抗体作为组合诊断标记物可提高 SSc 患者 PBC 的检出率。CENP-B 和 ATA 与碱性磷酸酶升高相关。
