Sørlandet Hospital Arendal, Department of Medicine, Section for Gastroenterology, Arendal, Norway.
J Crohns Colitis. 2008 Jun;2(2):114-22. doi: 10.1016/j.crohns.2007.10.001. Epub 2007 Nov 26.
Perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) have been proposed as markers for diagnosis and for subtyping of inflammatory bowel disease (IBD). The aim of this study was to investigate the association of p-ANCA and ASCA with a 10-year disease outcome in terms of cumulative rate of colectomy and relapse in a population-based European inception cohort of ulcerative colitis (UC) patients.
Serum samples from 432 consenting patients were analysed for p-ANCA and ASCA. The results were compared with the cumulative colectomy rate, relapsing disease and total number of relapses. We used multiple regression analyses adjusted for age, sex, residence, disease extent at diagnosis, smoking, familial IBD and drug treatment to study the relationship between serological values and disease course.
The relapse rate was higher in the p-ANCA-positive patients: 82% (95% confidence interval [CI] 75-89%) compared with 67% (CI 62-72%, p=0.011) in the p-ANCA-negative patients. The risk of relapsing disease course was higher by a factor of 1.4 (CI 1.1-1.8, p=0.009) for p-ANCA-positive patients than for p-ANCA-negative patients, and the corresponding relative risk (RR) for the total number of relapses was 1.9 (CI 1.7-2.1, p<0.001). In ASCA-positive patients RR for the total number of relapses was 1.8 (CI 1.5-2.1, p<0.001). No significant association with colectomy rate was found for the presence of either p-ANCA or ASCA.
UC patients positive for p-ANCA and possibly for ASCA may have a more unfavourable long-term disease outcome in terms of relapse than UC patients without these markers.
核周抗中性粒细胞胞浆抗体（p-ANCA）和抗酿酒酵母抗体（ASCA）已被提议作为诊断和炎症性肠病（IBD）亚型的标志物。本研究旨在调查 p-ANCA 和 ASCA 与溃疡性结肠炎（UC）患者人群的 10 年疾病结局（累积结肠切除术率和复发率）之间的关联。
对 432 名同意的患者的血清样本进行 p-ANCA 和 ASCA 分析。将结果与累积结肠切除术率、复发疾病和总复发次数进行比较。我们使用多元回归分析，调整了年龄、性别、居住地、诊断时的疾病范围、吸烟、家族性 IBD 和药物治疗，以研究血清学值与疾病过程之间的关系。
p-ANCA 阳性患者的复发率更高：82%（95%置信区间[CI] 75-89%），而 p-ANCA 阴性患者为 67%（CI 62-72%，p=0.011）。p-ANCA 阳性患者的复发疾病风险比 p-ANCA 阴性患者高 1.4 倍（CI 1.1-1.8，p=0.009），而总复发次数的相应相对风险（RR）为 1.9（CI 1.7-2.1，p<0.001）。ASCA 阳性患者的总复发次数 RR 为 1.8（CI 1.5-2.1，p<0.001）。p-ANCA 或 ASCA 的存在与结肠切除术率均无显著关联。
与无这些标志物的 UC 患者相比，p-ANCA 和可能 ASCA 阳性的 UC 患者在复发方面可能具有更不利的长期疾病结局。
