Shortcomings of the Inflammatory Bowel Disease Serology 7 Panel
Shortcomings of the Inflammatory Bowel Disease Serology 7 Panel
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DOI：
10.1542/peds.2009-1936
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发表时间：
2010-06-01
期刊：
影响因子：
8
通讯作者：
Winter, Harland S.
中科院分区：
文献类型：
--
作者：
Benor, Shira;Russell, George H.;Winter, Harland S.
目的：目的是比较Prometheus炎症性肠病（IBD）血清学7（IBD 7）组的预测值（Prometheus Laboratories，San Diego，CA）与常规血液测试在被转诊用于疑似IBD的初始评估的儿童群体中的预测值进行比较。儿科患者的医疗记录，这些患者被转诊接受IBD评价，并于2010年1月至2011年1月期间在Prometheus实验室进行了IBD 7检测。2006年和2008年11月进行了审查。患者由儿科胃肠病学家根据临床、影像学、内镜和病理评估进行诊断。我们根据年龄>21岁、既往IBD诊断或诊断不明确排除了90例记录。该队列中IBD的患病率为38%。血清学检查的敏感性、特异性、阳性预测值、阴性预测值和kappa值分别为67%、76%、63%、79%和42%，而3项常规实验室检查结果异常的组合值分别为72%、94%、85%、79%和47%。抗鞭毛蛋白抗体测定法是最新加入的测定法，其灵敏度为50%，特异性为53%。重复血清学检测未能产生一致的结果为4 10 patients.CONCLUSION：尽管其最近列入的抗鞭毛蛋白测定，IBD 7面板具有较低的预测值比常规的实验室检查在儿科IBD筛查。儿科2010; 125：1230-1236
OBJECTIVE: The goal was to compare the predictive values of the Prometheus Inflammatory Bowel Disease (IBD) Serology 7 (IBD7) panel (Prometheus Laboratories, San Diego, CA) with the predictive values of routine blood tests in a population of children referred for initial evaluation of suspected IBD.METHODS: Medical records of pediatric patients referred for evaluation of IBD for whom IBD7 testing was performed at Prometheus Laboratories between January 2006 and November 2008 were reviewed. Patients underwent diagnosis by pediatric gastroenterologists on the basis of clinical, radiologic, endoscopic, and pathologic evaluations.RESULTS: A total of 394 records were identified. We excluded 90 records on the basis of age of >21 years, previous diagnosis of IBD, or unclear diagnosis. The prevalence of IBD in this cohort was 38%. The sensitivity, specificity, positive predictive value, negative predictive value, and kappa value for the serological panel were 67%, 76%, 63%, 79%, and 42%, respectively, compared with values for a combination of 3 abnormal routine laboratory test results of 72%, 94%, 85%, 79%, and 47%. The antiflagellin antibody assay, the newest assay added to the panel, had sensitivity of 50% and specificity of 53%. Repeat serological testing failed to produce consistent results for 4 of 10 patients.CONCLUSION: Despite its recent inclusion of the antiflagellin assay, the IBD7 panel has lower predictive values than routine laboratory tests in pediatric screening for IBD. Pediatrics 2010; 125: 1230-1236