Takedatsu Hidetoshi, Mitsuyama Keiichi, Fukunaga Shuhei, Yoshioka Shinichiro, Yamauchi Ryosuke, Mori Atsushi, Yamasaki Hiroshi, Kuwaki Kotaro, Sakisaka Hideto, Sakisaka Shotaro, Torimura Takuji
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
J Gastroenterol Hepatol. 2018 Mar 7. doi: 10.1111/jgh.14140.
Proteinase 3 antineutrophil cytoplasmic antibodies (PR3-ANCAs) are well-known serological markers for granulomatosis with polyangiitis, but their role as serological markers for inflammatory bowel disease remains uncertain. The present study aimed to evaluate the diagnostic and clinical role of PR3-ANCAs as markers for inflammatory bowel disease.
Using a new methodology with chemiluminescence enzyme immunoassay, serum PR3-ANCA titers were assessed in 102 patients with ulcerative colitis (UC), 67 patients with Crohn's disease (CD), 44 controls with other intestinal diseases, and 66 healthy controls. Associations with clinical data were investigated. The diagnostic role of PR3-ANCAs was evaluated by receiver operating characteristic analysis.
Proteinase 3 antineutrophil cytoplasmic antibody titers were significantly higher in patients with UC than in those with CD patients, patients with intestinal diseases (intestinal controls), and healthy controls (all P < 0.001). Receiver operating characteristic analysis demonstrated an area under the curve of 0.85 (95% confidence interval: 0.83-0.87) and showed that the manufacturer's cutoff value (3.5 U/mL) had a sensitivity of 39.2% and specificity of 96.6% for UC. There was a significant difference between PR3-ANCA-positive and PR3-ANCA-negative patients with regard to disease duration (P < 0.05) and disease severity (P < 0.01).
Proteinase 3 antineutrophil cytoplasmic antibodies were significantly more prevalent in patients with UC than in those with CD and controls. Our results suggested the role of PR3-ANCAs as serological markers for aiding in diagnosing UC and evaluating disease severity. Further prospective studies are needed across multiple populations of patients and ethnic groups.
蛋白酶3抗中性粒细胞胞浆抗体（PR3-ANCA）是肉芽肿性多血管炎的著名血清学标志物，但其作为炎症性肠病血清学标志物的作用仍不确定。本研究旨在评估PR3-ANCA作为炎症性肠病标志物的诊断和临床作用。
采用化学发光酶免疫分析新方法，对102例溃疡性结肠炎（UC）患者、67例克罗恩病（CD）患者、44例其他肠道疾病对照者和66例健康对照者的血清PR3-ANCA滴度进行评估。研究其与临床数据的相关性。通过受试者工作特征分析评估PR3-ANCA的诊断作用。
UC患者的蛋白酶3抗中性粒细胞胞浆抗体滴度显著高于CD患者、肠道疾病患者（肠道对照）和健康对照（均P<0.001）。受试者工作特征分析显示曲线下面积为0.85（95%置信区间：0.83-0.87），表明制造商的临界值（3.5 U/mL）对UC的敏感性为39.2%，特异性为96.6%。PR3-ANCA阳性和阴性患者在疾病持续时间（P<0.05）和疾病严重程度（P<0.01）方面存在显著差异。
蛋白酶3抗中性粒细胞胞浆抗体在UC患者中的患病率显著高于CD患者和对照者。我们的结果提示PR3-ANCA作为血清学标志物有助于诊断UC并评估疾病严重程度。需要在多个患者群体和种族中进行进一步的前瞻性研究。
