Department of Gastroenterology, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan 430071, People's Republic of China.
Clin Chim Acta. 2010 Oct 9;411(19-20):1461-5. doi: 10.1016/j.cca.2010.05.041. Epub 2010 Jun 4.
Perinuclear anti-neutrophil cytoplasmic (pANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) have been studied extensively in Western countries. We determined the prevalence of pANCA and ASCA in the mainland Chinese population and the ability of pANCA and ASCA to discriminate between ulcerative colitis (UC) and Crohn's disease (CD).
Two hundred-six unrelated patients with IBD (UC, n=152; CD, n=54), 60 patients with other gastrointestinal diseases, and 80 healthy controls were included. Sera pANCA and ASCA titers were determined by a standardized indirect immunofluorescence technique.
The sensitivity, specificity, positive and negative predictive values, and positive likelihood ratio of pANCA were calculated for differentiating UC from healthy controls (43.4%, 96.3%, 95.7%, 47.2%, and 11.7, respectively) and ASCA for differentiating CD from healthy controls and (46.3%, 96.3%, 89.3%, 72.6%, and 12.5, respectively). The combination of pANCA and ASCA did not result in greater diagnostic efficiency than either test alone. pANCA was more frequent in UC with extensive or severe phenotype than others. ASCA was associated with severe CD disease activity.
pANCA and ASCA are useful in confirming the diagnosis of IBD and differentiating between UC and CD in an IBD cohort in central China.
核周抗中性粒细胞胞浆抗体（pANCA）和抗酿酒酵母抗体（ASCA）在西方国家已得到广泛研究。我们确定了中国大陆人群中 pANCA 和 ASCA 的流行率，以及 pANCA 和 ASCA 鉴别溃疡性结肠炎（UC）和克罗恩病（CD）的能力。
纳入 206 例无相关性的 IBD 患者（UC，n=152；CD，n=54）、60 例其他胃肠道疾病患者和 80 例健康对照者。采用标准化间接免疫荧光技术检测血清 pANCA 和 ASCA 滴度。
计算 pANCA 鉴别 UC 与健康对照者（43.4%、96.3%、95.7%、47.2%和 11.7）和 ASCA 鉴别 CD 与健康对照者和（46.3%、96.3%、89.3%、72.6%和 12.5）的灵敏度、特异性、阳性和阴性预测值及阳性似然比。pANCA 和 ASCA 联合应用并未比单独应用任何一种检测方法具有更高的诊断效率。广泛或严重表型的 UC 患者 pANCA 更为常见。ASCA 与严重 CD 疾病活动有关。
pANCA 和 ASCA 有助于在中国大陆的 IBD 患者中确认 IBD 的诊断，并鉴别 UC 和 CD。
