Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Inflamm Bowel Dis. 2012 Oct;18(10):1872-84. doi: 10.1002/ibd.22862. Epub 2012 Jan 31.
Anti-glycan antibody serologic markers may serve as a useful adjunct in the diagnosis/prognosis of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This meta-analysis/systemic review aimed to evaluate the diagnostic value, as well as the association of anti-glycan biomarkers with IBD susceptible gene variants, disease complications, and the need for surgery in IBD.
The diagnostic odds ratio (DOR), 95% confidence interval (CI), and sensitivity/specificity were used to compare the diagnostic value of individual and combinations of anti-glycan markers and their association with disease course (complication and/or need for surgery).
Fourteen studies were included in the systemic review and nine in the meta-analysis. Individually, anti-Saccharomyces cervisiae antibodies (ASCA) had the highest DOR for differentiating IBD from healthy (DOR 21.1; 1.8-247.3; two studies), and CD from UC (DOR 10.2; CI 7.7-13.7; seven studies). For combination of ≥2 markers, the DOR was 2.8 (CI 2.2-3.6; two studies) for CD-related surgery, higher than any individual marker, while the DOR for differentiating CD from UC was 10.2 (CI 5.6-18.5; three studies) and for complication was 2.8 (CI 2.2-3.7; two studies), similar to individual markers.
ASCA had the highest diagnostic value among individual anti-glycan markers. While anti-chitobioside carbohydrate antibody (ACCA) had the highest association with complications, ASCA and ACCA associated equally with the need for surgery. Although in most individual studies the combination of ≥2 markers had a better diagnostic value as well as higher association with complications and need for surgery, we found the combination performing slightly better than any individual marker in our meta-analysis.
抗聚糖抗体血清标志物可作为炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC）的诊断/预后的有用辅助手段。本荟萃分析/系统综述旨在评估抗聚糖生物标志物的诊断价值，以及与 IBD 易感基因变异、疾病并发症和 IBD 手术需求的相关性。
采用诊断优势比（DOR）、95%置信区间（CI）和敏感性/特异性来比较单个和组合抗聚糖标志物的诊断价值，以及它们与疾病病程（并发症和/或手术需求）的相关性。
系统综述纳入了 14 项研究，荟萃分析纳入了 9 项研究。单独使用时，抗酿酒酵母抗体（ASCA）在区分 IBD 与健康人群（DOR 21.1；1.8-247.3；两项研究）和 CD 与 UC（DOR 10.2；CI 7.7-13.7；七项研究）方面具有最高的诊断价值。对于≥2 种标志物的组合，CD 相关手术的 DOR 为 2.8（CI 2.2-3.6；两项研究），高于任何单个标志物，而 CD 与 UC 的 DOR 为 10.2（CI 5.6-18.5；三项研究），并发症的 DOR 为 2.8（CI 2.2-3.7；两项研究），与单个标志物相似。
在单个抗聚糖标志物中，ASCA 具有最高的诊断价值。虽然抗壳二糖抗体（ACCA）与并发症的相关性最高，但 ASCA 和 ACCA 与手术需求的相关性相同。虽然在大多数单独的研究中，≥2 种标志物的组合具有更好的诊断价值，并且与并发症和手术需求的相关性更高，但我们发现组合在荟萃分析中的表现略优于任何单个标志物。
